Amends the New York Health Care Reform Act of 1996 and 2000, extends time provisions related thereto; expands the child health insurance plan, extends distribution of pool allocations; amends chapter 703 of the laws of 1998 relating to expanded health care and catastrophic health care coverage; amends chapter 731 of 1993 relating to reimbursement, delivery and capital costs of ambulatory health care services and inpatient services; relates to elderly pharmaceutical insurance coverage program; to the early intervention program and account; to the office of professional medical conduct; and to physician biennial licensing fees; extends the expanded syringe access demonstration program; requires body mass index screening for school children; enacts into law major components of legislation necessary to implement the health, mental health budget for the 2007-2008 state fiscal year; makes various provisions relating to medical reimbursement and welfare reform, rates for residential health care facilities; relates to medical assistance eligibility of certain persons and providing for managed medical care demonstration programs; relates to payments for medical assistance; relates to the method of payment for prescription drugs under medical assistance programs; relates to health care providers; add crimes relating to health care fraud; relates to encouraging comprehensive health services and health reform; and various other provisions; repeals certain provisions relating thereto; relates to mental health provider assessments; relates to establishment of programs promoting culturally and linguistically competent mental health; relates to creating the mental retardation and developmental disabilities service quality improvement demonstration program; relates to reviewing medicaid reimbursement for the provision of long term therapies and psychotherapy for certain licenses clinical social workers; establishes the empire state stem cell board and establishes the empire state stem cell trust fund.
STATE OF NEW YORK
________________________________________________________________________
S. 2108--C A. 4308--C
R.R. 24
SENATE - ASSEMBLY
January 31, 2007
___________
IN SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
cle seven of the Constitution -- read twice and ordered printed, and
when printed to be committed to the Committee on Finance -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
IN ASSEMBLY -- A BUDGET BILL, submitted by the Governor pursuant to
article seven of the Constitution -- read once and referred to the
Committee on Ways and Means -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee --
again reported from said committee with amendments, ordered reprinted
as amended and recommitted to said committee -- reported and referred
to the Committee on Rules -- passed by Assembly and delivered to the
Senate, recalled from the Senate, vote reconsidered, restored to
special order on third reading, recommitted to the Committee on Ways
and Means -- committee discharged, bill amended, ordered reprinted as
amended and recommitted to said committee
AN ACT to amend the New York Health Care Reform Act of 1996, in relation
to extending certain provisions relating thereto; to amend the New
York Health Care Reform Act of 2000, in relation to extending the
effectiveness of provisions thereof; to amend the public health law,
in relation to the distribution of pool allocations and graduate
medical education; to amend chapter 62 of the laws of 2003 amending
the general business law and other laws relating to enacting major
components necessary to implement the state fiscal plan for the 2003-
04 state fiscal year, in relation to the deposit of certain funds; to
amend the public authorities law, in relation to the transfer of
certain funds; to amend chapter 2 of the laws of 1998 amending the
public health law and other laws relating to expanding the child
health insurance plan, in relation to the effectiveness of certain
provisions thereof; to amend chapter 703 of the laws of 1988 relating
to enacting the expanded health care coverage act of nineteen hundred
eighty-eight and amending the insurance law and other laws relating to
expanded health care and catastrophic health care coverage, in
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD12171-06-7
S. 2108--C 2 A. 4308--C
relation to extending certain provisions thereof; to amend the public
health law, in relation to continuing the priority restoration adjust-
ment; to amend chapter 731 of the laws of 1993 amending the public
health law and other laws relating to reimbursement, delivery and
capital costs of ambulatory health care services and inpatient hospi-
tal services, in relation to extending the effectiveness of portions
thereof; to amend the social services law, in relation to extending
payment provisions for general hospitals; to amend chapter 600 of the
laws of 1986 amending the public health law relating to development of
pilot reimbursement programs for ambulatory care services, in relation
to the effectiveness of such chapter; to amend chapter 753 of the laws
of 1989 amending the public health law and other laws relating to
general hospital reimbursement for inpatient and ambulatory surgery,
in relation to the effectiveness of portions thereof; to amend chapter
520 of the laws of 1978 relating to providing for a comprehensive
survey of health care financing, education and illness prevention and
creating councils for the conduct thereof, in relation to extending
the effectiveness of portions thereof; to amend the public health law,
in relation to extending access to community health care services in
rural areas; to amend chapter 266 of the laws of 1986 amending the
civil practice law and rules and other laws relating to malpractice
and professional medical conduct, in relation to extending the appli-
cability of certain provisions thereof; to amend chapter 63 of the
laws of 2001 amending chapter 20 of the laws of 2001 amending the
military law and other laws relating to making appropriations for the
support of government, in relation to extending the applicability of
certain provisions thereof; to amend the insurance law, in relation to
liquidation of domestic insurers; to amend the public health law, in
relation to the comprehensive diagnostic and treatment centers indi-
gent care program; to amend the public health law, in relation to
certain audits being deemed presumptively correct; to amend the insur-
ance law, in relation to article forty-three corporations; to amend
chapter 82 of the laws of 2002 amending the environmental conservation
law and other laws relating to certain portions of funds borrowed, in
relation to extending the length of time related to the borrowing of
certain funds; to amend the state finance law, in relation to extend-
ing the suspension of certain provisions; to repeal provisions of the
social services law relating to eligibility for medical assistance; to
amend chapter 109 of the laws of 2006 amending the social services law
and other laws relating to Medicaid reimbursement rate settings; to
amend the public health law, in relation to payments for non-public
general hospitals; to amend chapter 495 of the laws of 2004 amending
the insurance law and the public health law relating to the New York
state health insurance continuation assistance demonstration project,
in relation to the effectiveness of such provisions; to amend the
insurance law, in relation to the definition of dependent children;
and to amend the public health law, in relation to inpatient rate
adjustments (Part A); to amend the elder law, in relation to the
elderly pharmaceutical insurance coverage program, program eligibility
and the generic drug dispensing fee; to amend chapter 62 of the laws
of 2003, amending the public health law relating to allowing for the
use of funds of the office of professional medical conduct for activ-
ities of the patient health information and quality improvement act of
2000, in relation to the effectiveness thereof; to amend the education
law, in relation to biennial licensing fees for physicians; to amend
chapter 56 of the laws of 2000, amending the public health law, the
S. 2108--C 3 A. 4308--C
general business law and the insurance law relating to the sale and
possession of hypodermic syringes and needles, in relation to making
permanent the expanded syringe access demonstration program; to amend
chapter 198 of the laws of 1978, relating to authorizing projects to
provide improved and expanded school health services for pre-school
and school-age children, in relation to authorized projects; to amend
the state finance law, in relation to the federal-state health reform
partnership program account; to amend the education law, in relation
to including body mass index screening for school children; to amend
the state finance law, in relation to establishing the medicaid train-
ing contract account; to amend the elder law, in relation to programs
for the aging; to amend the public health law, in relation to hypo-
dermic needles and syringes; to amend the education law, in relation
to student health certificates; to amend the social services law, in
relation to assisted living; and to repeal certain provisions of the
public health law relating to the health information technology demon-
stration program; (Part B); to amend the social services law and the
public health law, in relation to family health care plus, managed
long term care plans, insurance payments, prescription drugs, general
hospital reimbursements, hospital assessments, rates of payment for
residential health care facilities, and the long term care demon-
stration program; to amend the long term care integration and finance
act of 1997, in relation to extending the effectiveness thereof; to
amend the state finance law, in relation to enacting the "New York
False Claims Act"; to amend the workers' compensation law, in relation
to confidentiality of workers' compensation records; to amend the tax
law, in relation to general powers of the tax commission; to amend the
social services law, in relation to claims and false statements; to
amend the social services law and chapter 58 of the laws of 2005,
amending the public health law and other laws relating to authorizing
reimbursements for expenditures made by social services districts for
medical assistance, in relation to medical assistance for needy
persons; to amend chapter 483 of the laws of 1978, amending the public
health law relating to rate of payment for each residential health
care facility to real property costs, in relation to making certain
provisions permanent; to amend chapter 474 of the laws of 1996, amend-
ing the education law and other laws relating to rates for residential
health care facilities, the public health law and chapter 639 of the
laws of 1996, amending the public health law and other laws relating
to welfare reform, in relation to reimbursements; to amend chapter 884
of the laws of 1990, amending the public health law relating to
authorizing bad debt and charity care allowances for certified home
health agencies, in relation to the effectiveness thereof; to amend
chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, in
relation to reimbursements and the effectiveness thereof; to repeal
certain provisions of the public health law relating thereto; and
providing for the repeal of certain provisions upon expiration thereof
(Part C); to amend the mental hygiene law, in relation to provider
assessments (Part D); to amend the mental hygiene law, in relation to
the establishment of programs promoting culturally and linguistically
competent mental health (Part E); to amend the mental hygiene law, in
relation to creating the mental retardation and developmental disabil-
ities services quality improvement demonstration program (Part F);
relating to reviewing medicaid reimbursement for the provision of long
term therapies and psychotherapy by certain licensed clinical social
S. 2108--C 4 A. 4308--C
workers (Part G); and to amend the public health law, the public offi-
cers law and the state finance law, in relation to establishing the
empire state stem cell board (Part H)
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. This act enacts into law major components of legislation
2 which are necessary to implement the state fiscal plan for the 2007-2008
3 state fiscal year. Each component is wholly contained within a Part
4 identified as Parts A through H. The effective date for each particular
5 provision contained within such Part is set forth in the last section of
6 such Part. Any provision in any section contained within a Part, includ-
7 ing the effective date of the Part, which makes a reference to a section
8 "of this act", when used in connection with that particular component,
9 shall be deemed to mean and refer to the corresponding section of the
10 Part in which it is found. Section three of this act sets forth the
11 general effective date of this act.
12 PART A
13 Section 1. Subdivision 5 of section 168 of chapter 639 of the laws of
14 1996, constituting the New York Health Care Reform Act of 1996, as
15 amended by section 1 of part B of chapter 58 of the laws of 2005, is
16 amended to read as follows:
17 5. sections 2807-c, 2807-j, 2807-s and 2807-t of the public health
18 law, as amended or as added by this act, shall expire on [July 1, 2007]
19 December 31, 2008, and shall be thereafter effective only in respect to
20 any act done on or before such date or action or proceeding arising out
21 of such act including continued collections of funds from assessments
22 and allowances and surcharges established pursuant to sections 2807-c,
23 2807-j, 2807-s and 2807-t of the public health law, and administration
24 and distributions of funds from pools established pursuant to sections
25 2807-c, 2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
26 health law related to patient services provided before [July 1, 2007]
27 December 31, 2008, and continued expenditure of funds authorized for
28 programs and grants until the exhaustion of funds therefor;
29 § 2. Subdivision 1 of section 138 of chapter 1 of the laws of 1999,
30 constituting the New York Health Care Reform Act of 2000, as amended by
31 section 2 of part B of chapter 58 of the laws of 2005, is amended to
32 read as follows:
33 1. sections 2807-c, 2807-j, 2807-s, and 2807-t of the public health
34 law, as amended by this act, shall expire on [July 1, 2007] December 31,
35 2008, and shall be thereafter effective only in respect to any act done
36 before such date or action or proceeding arising out of such act includ-
37 ing continued collections of funds from assessments and allowances and
38 surcharges established pursuant to sections 2807-c, 2807-j, 2807-s and
39 2807-t of the public health law, and administration and distributions of
40 funds from pools established pursuant to sections 2807-c, 2807-j,
41 2807-k, 2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public
42 health law, as amended or added by this act, related to patient services
43 provided before [July 1, 2007] December 31, 2008, and continued expendi-
44 ture of funds authorized for programs and grants until the exhaustion of
45 funds therefor;
S. 2108--C 5 A. 4308--C
1 § 3. Paragraph (a) of subdivision 9 of section 2807-j of the public
2 health law, as amended by chapter 1 of the laws of 1999, subparagraphs
3 (iv), (v) and (vi) as amended by section 53 of part B of chapter 58 of
4 the laws of 2005, is amended to read as follows:
5 (a) funds shall be deposited and credited to a special revenue-other
6 fund to be established by the comptroller or to the health care reform
7 act (HCRA) resources fund established pursuant to section ninety-two-dd
8 of the state finance law, whichever is applicable. To the extent of
9 funds appropriated therefore, the commissioner shall make payments to
10 general hospitals related to bad debt and charity care pursuant to
11 section twenty-eight hundred seven-k of this article. Funds shall be
12 deposited in the following amounts:
13 (i) fifty-seven and thirty-three-hundredths percent of the funds accu-
14 mulated for the period January first, nineteen hundred ninety-seven
15 through December thirty-first, nineteen hundred ninety-seven,
16 (ii) fifty-seven and one-hundredths percent of the funds accumulated
17 for the period January first, nineteen hundred ninety-eight through
18 December thirty-first, nineteen hundred ninety-eight,
19 (iii) fifty-five and thirty-two-hundredths percent of the funds accu-
20 mulated for the period January first, nineteen hundred ninety-nine
21 through December thirty-first, nineteen hundred ninety-nine, and
22 (iv) seven hundred sixty-five million dollars annually of the funds
23 accumulated for the periods January first, two thousand through December
24 thirty-first, two thousand [six] seven, and
25 (v) [three] one hundred [eighty-two] ninety-one million [five] two
26 hundred fifty thousand dollars of the funds accumulated for the period
27 January first, two thousand [seven] eight through [June thirtieth] March
28 thirty-first, two thousand [seven] eight, [and
29 (vi) if funds accumulated for distributions pursuant to section twen-
30 ty-eight hundred seven-k of this article are insufficient to meet the
31 funding requirements established pursuant to subparagraphs (iv) and (v)
32 of this paragraph, the commissioner, or the state comptroller as appli-
33 cable, is authorized to transfer and deposit funds accumulated pursuant
34 to section twenty-eight hundred seven-v of this article into the special
35 revenue funds - other, indigent care fund - 068, or any successor fund
36 or account, to fully fund the amounts established pursuant to subpara-
37 graphs (iv) and (v) of this paragraph; provided however, the provisions
38 of this subparagraph shall only be effective after funding amounts spec-
39 ified in subparagraph (viii) of paragraph (a) of subdivision one of
40 section twenty-eight hundred seven-l of this article].
41 § 4. Section 34 of part A3 of chapter 62 of the laws of 2003 amending
42 the general business law and other laws relating to enacting major
43 components necessary to implement the state fiscal plan for the 2003-04
44 state fiscal year, as amended by section 68 of part B of chapter 58 of
45 the laws of 2005, is amended to read as follows:
46 § 34. (1) Notwithstanding any inconsistent provision of law, rule or
47 regulation, the commissioner of health is authorized to transfer and the
48 state comptroller is authorized and directed to receive for deposit to
49 the credit of the department of health's special revenue fund - other,
50 [miscellaneous special revenue fund - 339] health care reform act (HCRA)
51 resources fund - 061, provider collection monitoring account, [or any
52 successor fund or account,] within amounts appropriated, those funds
53 collected and accumulated pursuant to section 2807-v of the public
54 health law, including income from invested funds, for the purpose of
55 payment for administrative costs of the department of health related to
S. 2108--C 6 A. 4308--C
1 administration of statutory duties for the collections and distributions
2 authorized by section 2807-v of the public health law.
3 (2) Notwithstanding any inconsistent provision of law, rule or regu-
4 lation, the commissioner of health is authorized to transfer and the
5 state comptroller is authorized and directed to receive for deposit to
6 the credit of the department of health's special revenue fund - other,
7 health care reform act (HCRA) resources fund - 061, provider collection
8 monitoring account, within amounts appropriated, those funds collected
9 and accumulated and interest earned through surcharges on payments for
10 health care services pursuant to section 2807-s of the public health law
11 and from assessments pursuant to section 2807-t of the public health law
12 for the purpose of payment for administrative costs of the department of
13 health related to administration of statutory duties for the collections
14 and distributions authorized by sections 2807-s, 2807-t, and 2807-m of
15 the public health law [into such accounts established within the depart-
16 ment of health for such purposes].
17 (3) Notwithstanding any inconsistent provision of law, rule or regu-
18 lation, the commissioner of health is authorized to transfer and the
19 comptroller is authorized to deposit, within amounts appropriated, those
20 funds authorized for distribution in accordance with the provisions of
21 paragraph (a) of subdivision 1 of section 2807-l of the public health
22 law for the purposes of payment for administrative costs of the depart-
23 ment of health related to the child health insurance plan program
24 authorized pursuant to title 1-A of article 25 of the public health law
25 into the special revenue funds - other, [miscellaneous special revenue
26 fund - 339,] health care reform act (HCRA) resources fund - 061, child
27 health insurance account, [or any successor fund or account,] estab-
28 lished within the department of health.
29 (4) Notwithstanding any inconsistent provision of law, rule or regu-
30 lation, the commissioner of health is authorized to transfer and the
31 comptroller is authorized to deposit, within amounts appropriated, those
32 funds authorized for distribution in accordance with the provisions of
33 paragraph (e) of subdivision 1 of section 2807-1 of the public health
34 law for the purpose of payment for administrative costs of the depart-
35 ment of health related to the health occupation development and work-
36 place demonstration program established pursuant to section 2807-h and
37 the health workforce retraining program established pursuant to section
38 2807-g of the public health law into the special revenue funds - other,
39 [miscellaneous special revenue fund - 339,] health care reform act
40 (HCRA) resources fund - 061, health occupation development and workplace
41 demonstration program account, [or any successor fund or account,]
42 established within the department of health.
43 (5) Notwithstanding any inconsistent provision of law, rule or regu-
44 lation, the commissioner of health is authorized to transfer and the
45 comptroller is authorized to deposit [two million six hundred thousand
46 dollars ($2,600,000), or so much thereof as may be necessary, annually
47 of], within amounts appropriated, those funds allocated pursuant to
48 paragraph (j) of subdivision 1 of section 2807-v of the public health
49 law for the purpose of payment for administrative costs of the depart-
50 ment of health related to administration of the state's tobacco control
51 programs and cancer services provided pursuant to sections 2807-r and
52 1399-ii of the public health law into such accounts established within
53 the department of health for such purposes.
54 (6) [Notwithstanding any inconsistent provision of law, rule or regu-
55 lation, the commissioner of health is authorized to transfer and deposit
56 seven hundred fifty thousand dollars ($750,000), or so much thereof as
S. 2108--C 7 A. 4308--C
1 may be necessary, annually of funds authorized for distribution in
2 accordance with the provisions of section 2807-l of the public health
3 law from monies accumulated and interest earned through funds authorized
4 for distribution in accordance with the provisions of section 2807-l of
5 the public health law for the purpose of payment for administrative
6 costs of the department of health related to programs funded pursuant to
7 section 2807-l of the public health law into the special revenue funds -
8 other, miscellaneous special revenue fund - 339, primary care initi-
9 atives monitoring account, or any successor fund or account, established
10 within the department of health.
11 (7)] Notwithstanding any inconsistent provision of law, rule or regu-
12 lation, the commissioner of health is authorized to transfer and the
13 comptroller is authorized to deposit, within amounts appropriated, the
14 funds authorized for distribution in accordance with the provisions of
15 section 2807-l of the public health law for the purposes of payment for
16 administrative costs of the department of health related to the programs
17 funded pursuant to section 2807-l of the public health law into the
18 special revenue funds - other, [miscellaneous special revenue fund -
19 339,] health care reform act (HCRA) resources fund - 061, pilot health
20 insurance account, [or any successor fund or account,] established with-
21 in the department of health.
22 [(8)] (7) Notwithstanding any inconsistent provision of law, rule or
23 regulation, the commissioner of health is authorized to transfer and the
24 comptroller is authorized to deposit, within amounts appropriated, those
25 funds authorized for distribution in accordance with the provisions of
26 subparagraph (ii) of paragraph (f) of subdivision 19 of section 2807-c
27 of the public health law from monies accumulated and interest earned in
28 the bad debt and charity care and capital statewide pools through an
29 assessment charged to general hospitals pursuant to the provisions of
30 subdivision 18 of section 2807-c of the public health law and those
31 funds authorized for distribution in accordance with the provisions of
32 section 2807-l of the public health law for the purposes of payment for
33 administrative costs of the department of health related to [monitoring
34 the implementation and effectiveness of] programs funded under section
35 2807-l of the public health law into the special revenue funds - other,
36 [miscellaneous special revenue fund - 339,] health care reform act
37 (HCRA) resources fund - 061, primary care initiatives [monitoring]
38 account, [or any successor fund or account,] established within the
39 department of health.
40 [(9)] (8) Notwithstanding any inconsistent provision of law, rule or
41 regulation, the commissioner of health is authorized to transfer and the
42 comptroller is authorized to deposit, within amounts appropriated, those
43 funds authorized for distribution in accordance with section 2807-l of
44 the public health law for the purposes of payment for administrative
45 costs of the department of health related to programs funded under
46 section 2807-l of the public health law into the special revenue funds -
47 other, [miscellaneous special revenue fund - 339,] health care reform
48 act (HCRA) resources fund - 061, health care delivery [improvement
49 grant] administration account, [or any successor fund or account,]
50 established within the department of health.
51 [(10)] (9) Notwithstanding any inconsistent provision of law, rule or
52 regulation, the commissioner of health is authorized to transfer and the
53 comptroller is authorized to deposit, within amounts appropriated, those
54 funds authorized pursuant to sections 2807-d, 3614-a and 3614-b of the
55 public health law and section 367-i of the social services law and for
56 distribution in accordance with the provisions of subdivision 9 of
S. 2108--C 8 A. 4308--C
1 section 2807-j of the public health law for the purpose of payment for
2 administration of statutory duties for the collections and distributions
3 authorized by sections 2807-c, 2807-d, 2807-j, 2807-k, 2807-l, 3614-a
4 and 3614-b of the public health law and section 367-i of the social
5 services law into the special revenue funds - other, [miscellaneous
6 special revenue fund - 339,] health care reform act (HCRA) resources
7 fund - 061, provider collection monitoring account, [or any successor
8 fund or account,] established within the department of health.
9 § 5. Section 2807-l of the public health law, as amended by section 19
10 of part B of chapter 58 of the laws of 2005, clause (A) of subparagraph
11 (i) of paragraph (b) of subdivision 1 as amended by section 10-a of part
12 D of chapter 57 of the laws of 2006, paragraphs (c), (d) and (f) of
13 subdivision 1 as amended by section 5 of part E of chapter 63 of the
14 laws of 2005 and paragraph (e) of subdivision 1 as amended by section 19
15 of part E of chapter 63 of the laws of 2005 and subparagraph (v) of
16 paragraph (k) of subdivision 1 as amended by section 10-c-2 of part D of
17 chapter 57 of the laws of 2006, is amended to read as follows:
18 § 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
19 lated in the health care initiatives pools pursuant to paragraph (b) of
20 subdivision nine of section twenty-eight hundred seven-j of this arti-
21 cle, or the health care reform act (HCRA) resources fund established
22 pursuant to section ninety-two-dd of the state finance law, whichever is
23 applicable, including income from invested funds, shall be distributed
24 or retained by the commissioner or by the state comptroller, as applica-
25 ble, in accordance with the following.
26 (a) Funds shall be reserved and accumulated from year to year and
27 shall be available, including income from invested funds, for purposes
28 of distributions to programs to provide health care coverage for unin-
29 sured or underinsured children pursuant to sections twenty-five hundred
30 ten and twenty-five hundred eleven of this chapter from the respective
31 health care initiatives pools established for the following periods in
32 the following amounts:
33 (i) from the pool for the period January first, nineteen hundred nine-
34 ty-seven through December thirty-first, nineteen hundred ninety-seven,
35 up to one hundred twenty million six hundred thousand dollars;
36 (ii) from the pool for the period January first, nineteen hundred
37 ninety-eight through December thirty-first, nineteen hundred ninety-
38 eight, up to one hundred sixty-four million five hundred thousand
39 dollars;
40 (iii) from the pool for the period January first, nineteen hundred
41 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
42 up to one hundred eighty-one million dollars;
43 (iv) from the pool for the period January first, two thousand through
44 December thirty-first, two thousand, two hundred seven million dollars;
45 (v) from the pool for the period January first, two thousand one
46 through December thirty-first, two thousand one, two hundred thirty-five
47 million dollars;
48 (vi) from the pool for the period January first, two thousand two
49 through December thirty-first, two thousand two, three hundred twenty-
50 four million dollars;
51 (vii) from the pool for the period January first, two thousand three
52 through December thirty-first, two thousand three, up to four hundred
53 fifty million three hundred thousand dollars;
54 (viii) from the pool for the period January first, two thousand four
55 through December thirty-first, two thousand four, up to four hundred
56 sixty million nine hundred thousand dollars;
S. 2108--C 9 A. 4308--C
1 (ix) from the pool or the health care reform act (HCRA) resources
2 fund, whichever is applicable, for the period January first, two thou-
3 sand five through December thirty-first, two thousand five, up to one
4 hundred fifty-three million eight hundred thousand dollars;
5 (x) from the [pool] health care reform act (HCRA) resources fund for
6 the period January first, two thousand six through December thirty-
7 first, two thousand six, up to three hundred twenty-five million four
8 hundred thousand dollars; [and]
9 (xi) from the [pool] health care reform act (HCRA) resources fund for
10 the period January first, two thousand seven through [June thirtieth]
11 December thirty-first, two thousand seven, up to [one] four hundred
12 [eighty-eight] twenty-eight million [nine hundred] fifty-nine thousand
13 dollars[.]; and
14 (xii) [If funds allocated pursuant to this paragraph are insufficient
15 to cover the costs required to meet the state's obligations established
16 in sections twenty-five hundred ten and twenty-five hundred eleven of
17 this chapter, the commissioner or the state comptroller, as applicable,
18 shall transfer and deposit funds accumulated pursuant to section twen-
19 ty-eight hundred seven-v of this article into the special revenue fund-
20 other, miscellaneous special revenue fund-339, child health insurance
21 account or any successor fund or account, such amounts necessary to
22 fully fund such obligations] from the health care reform act (HCRA)
23 resources fund for the period January first, two thousand eight through
24 March thirty-first, two thousand eight, up to one hundred thirteen
25 million five hundred fifteen thousand dollars.
26 (b) Funds shall be reserved and accumulated from year to year and
27 shall be available, including income from invested funds, for purposes
28 of distributions for health insurance programs under the individual
29 subsidy programs established pursuant to the expanded health care cover-
30 age act of nineteen hundred eighty-eight as amended, [and the
31 catastrophic health care expense program established pursuant to title
32 eleven-A of article five of the social services law] and for evaluation
33 of such programs from the respective health care initiatives pools or
34 the health care reform act (HCRA) resources fund, whichever is applica-
35 ble, established for the following periods in the following amounts:
36 (i) (A) an amount not to exceed six million dollars on an annualized
37 basis for the periods January first, nineteen hundred ninety-seven
38 through December thirty-first, nineteen hundred ninety-nine; up to six
39 million dollars for the period January first, two thousand through
40 December thirty-first, two thousand; up to five million dollars for the
41 period January first, two thousand one through December thirty-first,
42 two thousand one; up to four million dollars for the period January
43 first, two thousand two through December thirty-first, two thousand two;
44 up to two million six hundred thousand dollars for the period January
45 first, two thousand three through December thirty-first, two thousand
46 three; up to one million three hundred thousand dollars for the period
47 January first, two thousand four through December thirty-first, two
48 thousand four; up to six hundred seventy thousand dollars for the period
49 January first, two thousand five through June thirtieth, two thousand
50 five; [and] up to one million three hundred thousand dollars for the
51 period April first, two thousand six through March thirty-first, two
52 thousand seven; and up to one million three hundred thousand dollars for
53 the period April first, two thousand seven through March thirty-first,
54 two thousand eight, shall be allocated to individual subsidy programs;
55 and
S. 2108--C 10 A. 4308--C
1 (B) an amount not to exceed seven million dollars on an annualized
2 basis for the periods during the period January first, nineteen hundred
3 ninety-seven through December thirty-first, nineteen hundred ninety-nine
4 and four million dollars annually for the periods January first, two
5 thousand through December thirty-first, two thousand two, and three
6 million dollars for the period January first, two thousand three through
7 December thirty-first, two thousand three, and two million dollars for
8 the period January first, two thousand four through December thirty-
9 first, two thousand four, and two million dollars for the period January
10 first, two thousand five through June thirtieth, two thousand five shall
11 be allocated to the catastrophic health care expense program.
12 (ii) Notwithstanding any law to the contrary, the characterizations of
13 the New York state small business health insurance partnership program
14 as in effect prior to June thirtieth, two thousand three, voucher
15 program as in effect prior to December thirty-first, two thousand one,
16 individual subsidy program as in effect prior to June thirtieth, two
17 thousand five, and catastrophic health care expense program, as in
18 effect prior to June thirtieth, two thousand five, may, for the purposes
19 of identifying matching funds for the community health care conversion
20 demonstration project described in a waiver of the provisions of title
21 XIX of the federal social security act granted to the state of New York
22 and dated July fifteenth, nineteen hundred ninety-seven, may continue to
23 be used to characterize the insurance programs in sections four thousand
24 three hundred twenty-one-a, four thousand three hundred twenty-two-a,
25 four thousand three hundred twenty-six and four thousand three hundred
26 twenty-seven of the insurance law, which are successor programs to these
27 programs.
28 (c) Up to seventy-eight million dollars shall be reserved and accumu-
29 lated from year to year from the pool for the period January first,
30 nineteen hundred ninety-seven through December thirty-first, nineteen
31 hundred ninety-seven, for purposes of public health programs, up to
32 seventy-six million dollars shall be reserved and accumulated from year
33 to year from the pools for the periods January first, nineteen hundred
34 ninety-eight through December thirty-first, nineteen hundred ninety-
35 eight and January first, nineteen hundred ninety-nine through December
36 thirty-first, nineteen hundred ninety-nine, up to eighty-four million
37 dollars shall be reserved and accumulated from year to year from the
38 pools for the period January first, two thousand through December thir-
39 ty-first, two thousand, up to eighty-five million dollars shall be
40 reserved and accumulated from year to year from the pools for the period
41 January first, two thousand one through December thirty-first, two thou-
42 sand one, up to eighty-six million dollars shall be reserved and accumu-
43 lated from year to year from the pools for the period January first, two
44 thousand two through December thirty-first, two thousand two, up to
45 eighty-six million one hundred fifty thousand dollars shall be reserved
46 and accumulated from year to year from the pools for the period January
47 first, two thousand three through December thirty-first, two thousand
48 three, up to fifty-eight million seven hundred eighty thousand dollars
49 shall be reserved and accumulated from year to year from the pools for
50 the period January first, two thousand four through December thirty-
51 first, two thousand four, up to sixty-eight million seven hundred thirty
52 thousand dollars shall be reserved and accumulated from year to year
53 from the pools or the health care reform act (HCRA) resources fund,
54 whichever is applicable, for the period January first, two thousand five
55 through December thirty-first, two thousand five, up to ninety-four
56 million three hundred fifty thousand dollars shall be reserved and accu-
S. 2108--C 11 A. 4308--C
1 mulated from year to year from the [pools] health care reform act (HCRA)
2 resources fund for the period January first, two thousand six through
3 December thirty-first, two thousand six, [and] up to [forty-four] eight-
4 y-eight million [one hundred eighty] eighty-nine thousand dollars shall
5 be reserved and accumulated from year to year from the [pools] health
6 care reform act (HCRA) resources fund for the period January first, two
7 thousand seven through [June thirtieth] December thirty-first, two thou-
8 sand seven, and up to twenty-two million twenty-two thousand dollars
9 shall be reserved and accumulated from year to year from the health care
10 reform act (HCRA) resources fund for the period January first, two thou-
11 sand eight through March thirty-first, two thousand eight, and shall be
12 available, including income from invested funds, for:
13 (i) deposit by the commissioner, within amounts appropriated, and the
14 state comptroller is hereby authorized and directed to receive for
15 deposit to, to the credit of the department of health's special revenue
16 fund - other, hospital based grants program account [or any successor
17 fund or account] or the health care reform act (HCRA) resources fund,
18 whichever is applicable, for purposes of services and expenses related
19 to general hospital based grant programs, up to twenty-two million
20 dollars annually from the nineteen hundred ninety-seven pool, nineteen
21 hundred ninety-eight pool, nineteen hundred ninety-nine pool, two thou-
22 sand pool, two thousand one pool and two thousand two pool, respective-
23 ly, up to twenty-two million dollars from the two thousand three pool,
24 up to ten million dollars for the period January first, two thousand
25 four through December thirty-first, two thousand four, up to eleven
26 million dollars for the period January first, two thousand five through
27 December thirty-first, two thousand five, up to twenty-two million
28 dollars for the period January first, two thousand six through December
29 thirty-first, two thousand six, [and] up to [eleven] twenty-two million
30 ninety-seven dollars for the period January first, two thousand seven
31 through [June thirtieth] December thirty-first, two thousand seven, and
32 up to five million five hundred twenty-four thousand dollars for the
33 period January first, two thousand eight through March thirty-first, two
34 thousand eight;
35 (ii) deposit by the commissioner, within amounts appropriated, and the
36 state comptroller is hereby authorized and directed to receive for
37 deposit to, to the credit of the emergency medical services training
38 account established in section ninety-seven-q of the state finance law
39 [or any successor fund or account] or the health care reform act (HCRA)
40 resources fund, whichever is applicable, up to sixteen million dollars
41 on an annualized basis for the periods January first, nineteen hundred
42 ninety-seven through December thirty-first, nineteen hundred ninety-
43 nine, up to twenty million dollars for the period January first, two
44 thousand through December thirty-first, two thousand, up to twenty-one
45 million dollars for the period January first, two thousand one through
46 December thirty-first, two thousand one, up to twenty-two million
47 dollars for the period January first, two thousand two through December
48 thirty-first, two thousand two, up to twenty-two million five hundred
49 fifty thousand dollars for the period January first, two thousand three
50 through December thirty-first, two thousand three, up to nine million
51 six hundred eighty thousand dollars for the period January first, two
52 thousand four through December thirty-first, two thousand four, up to
53 twelve million one hundred thirty thousand dollars for the period Janu-
54 ary first, two thousand five through December thirty-first, two thousand
55 five, up to twenty-four million two hundred fifty thousand dollars for
56 the period January first, two thousand six through December thirty-
S. 2108--C 12 A. 4308--C
1 first, two thousand six, [and] up to [twelve] twenty million [one] four
2 hundred [thirty] ninety-two thousand dollars for the period January
3 first, two thousand seven through [June thirtieth] December
4 thirty-first, two thousand seven, and up to five million one hundred
5 twenty-three thousand dollars for the period January first, two thousand
6 eight through March thirty-first, two thousand eight;
7 (iii) priority distributions by the commissioner up to thirty-two
8 million dollars on an annualized basis for the period January first, two
9 thousand through December thirty-first, two thousand four, up to thir-
10 ty-eight million dollars on an annualized basis for the period January
11 first, two thousand five through December thirty-first, two thousand
12 six, and up to sixteen million dollars for the period January first, two
13 thousand seven through [June thirtieth] March thirty-first, two thousand
14 seven, to be allocated (A) for the purposes established pursuant to
15 subparagraph (ii) of paragraph (f) of subdivision nineteen of section
16 twenty-eight hundred seven-c of this article as in effect on December
17 thirty-first, nineteen hundred ninety-six and as may thereafter be
18 amended, up to fifteen million dollars annually for the periods January
19 first, two thousand through December thirty-first, two thousand four, up
20 to twenty-one million dollars annually for the period January first, two
21 thousand five through December thirty-first, two thousand six, and up to
22 seven million five hundred thousand dollars for the period January
23 first, two thousand seven through [June thirtieth] March thirty-first,
24 two thousand seven; [and]
25 (B) pursuant to a memorandum of understanding entered into by the
26 commissioner, the majority leader of the senate and the speaker of the
27 assembly, for the purposes outlined in such memorandum upon the recom-
28 mendation of the majority leader of the senate, up to eight million
29 five hundred thousand dollars annually for the period January first, two
30 thousand through December thirty-first, two thousand six, and up to four
31 million two hundred fifty thousand dollars for the period January first,
32 two thousand seven through June thirtieth, two thousand seven, and for
33 the purposes outlined in such memorandum upon the recommendation of the
34 speaker of the assembly, up to eight million five hundred thousand
35 dollars annually for the periods January first, two thousand through
36 December thirty-first, two thousand six, and up to four million two
37 hundred fifty thousand dollars for the period January first, two thou-
38 sand seven through June thirtieth, two thousand seven; and
39 (C) for services and expenses, including grants, related to emergency
40 assistance distributions as designated by the commissioner. Notwith-
41 standing section one hundred twelve or one hundred sixty-three of the
42 state finance law or any other contrary provision of law, such distrib-
43 utions shall be limited to providers or programs where, as determined by
44 the commissioner, emergency assistance is vital to protect the life or
45 safety of patients, to ensure the retention of facility caregivers or
46 other staff, or in instances where health facility operations are jeop-
47 ardized, or where the public health is jeopardized or other emergency
48 situations exist, up to three million dollars for the period April
49 first, two thousand seven through March thirty-first, two thousand
50 eight. Upon any distribution of such funds, the commissioner shall imme-
51 diately notify the chair and ranking minority member of the senate
52 finance committee, the assembly ways and means committee, the senate
53 committee on health, and the assembly committee on health;
54 (iv) distributions by the commissioner related to poison control
55 centers pursuant to subdivision seven of section twenty-five hundred-d
56 of this chapter, up to five million dollars for the period January
S. 2108--C 13 A. 4308--C
1 first, nineteen hundred ninety-seven through December thirty-first,
2 nineteen hundred ninety-seven, up to three million dollars on an annual-
3 ized basis for the periods during the period January first, nineteen
4 hundred ninety-eight through December thirty-first, nineteen hundred
5 ninety-nine, up to five million dollars annually for the periods January
6 first, two thousand through December thirty-first, two thousand two, up
7 to four million six hundred thousand dollars annually for the periods
8 January first, two thousand three through December thirty-first, two
9 thousand four, up to five million one hundred thousand dollars for the
10 period January first, two thousand five through December thirty-first,
11 two thousand six annually, [and] up to [two] five million [five] one
12 hundred [fifty] thousand dollars for the period January first, two thou-
13 sand seven through [June thirtieth] December thirty-first, two thousand
14 seven, and up to one million two hundred seventy-five thousand dollars
15 for the period January first, two thousand eight through March thirty-
16 first, two thousand eight; and
17 (v) deposit by the commissioner, within amounts appropriated, and the
18 state comptroller is hereby authorized and directed to receive for
19 deposit to, to the credit of the department of health's special revenue
20 fund - other, miscellaneous special revenue fund - 339 maternal and
21 child HIV services account or [any successor fund or account] the health
22 care reform act (HCRA) resources fund, whichever is applicable, for
23 purposes of a special program for HIV services for infants and pregnant
24 women pursuant to section seventy-one of chapter seven hundred thirty-
25 one of the laws of nineteen hundred ninety-three, amending the public
26 health law and other laws relating to reimbursement, delivery and capi-
27 tal costs of ambulatory health care services and inpatient hospital
28 services, up to five million dollars annually for the periods January
29 first, two thousand through December thirty-first, two thousand two, up
30 to five million dollars for the period January first, two thousand three
31 through December thirty-first, two thousand three, up to two million
32 five hundred thousand dollars for the period January first, two thousand
33 four through December thirty-first, two thousand four, up to two million
34 five hundred thousand dollars for the period January first, two thousand
35 five through December thirty-first, two thousand five, up to five
36 million dollars for the period January first, two thousand six through
37 December thirty-first, two thousand six, [and] up to [two] five million
38 [five hundred thousand] dollars for the period January first, two thou-
39 sand seven through [June thirtieth] December thirty-first, two thousand
40 seven, and up to one million two hundred fifty thousand dollars for the
41 period January first, two thousand eight through March thirty-first, two
42 thousand eight;
43 (d) (i) An amount of up to twenty million dollars annually for the
44 period January first, two thousand through December thirty-first, two
45 thousand six, and up to ten million dollars for the period January
46 first, two thousand seven through June thirtieth, two thousand seven,
47 shall be transferred to the health facility restructuring pool estab-
48 lished pursuant to section twenty-eight hundred fifteen of this article;
49 (ii) provided, however, amounts transferred pursuant to subparagraph
50 (i) of this paragraph may be reduced in an amount to be approved by the
51 director of the budget to reflect the amount received from the federal
52 government under the state's 1115 waiver which is directed under its
53 terms and conditions to the health facility restructuring program.
54 (e) Funds shall be reserved and accumulated from year to year and
55 shall be available, including income from invested funds, for purposes
56 of distributions to organizations to support the health workforce
S. 2108--C 14 A. 4308--C
1 retraining program established pursuant to section twenty-eight hundred
2 seven-g of this article from the respective health care initiatives
3 pools established for the following periods in the following amounts
4 from the pools or the health care reform act (HCRA) resources fund,
5 whichever is applicable, during the period January first, nineteen
6 hundred ninety-seven through December thirty-first, nineteen hundred
7 ninety-nine, up to fifty million dollars on an annualized basis, up to
8 thirty million dollars for the period January first, two thousand
9 through December thirty-first, two thousand, up to forty million dollars
10 for the period January first, two thousand one through December thirty-
11 first, two thousand one, up to fifty million dollars for the period
12 January first, two thousand two through December thirty-first, two thou-
13 sand two, up to forty-one million one hundred fifty thousand dollars for
14 the period January first, two thousand three through December thirty-
15 first, two thousand three, up to forty-one million one hundred fifty
16 thousand dollars for the period January first, two thousand four through
17 December thirty-first, two thousand four, up to fifty-eight million
18 three hundred sixty thousand dollars for the period January first, two
19 thousand five through December thirty-first, two thousand five, up to
20 fifty-two million three hundred sixty thousand dollars for the period
21 January first, two thousand six through December thirty-first, two thou-
22 sand six [and], up to [twenty-nine] thirty-five million [one] four
23 hundred [eighty] thousand dollars for the period January first, two
24 thousand seven through [June thirtieth] December thirty-first, two thou-
25 sand seven and up to fourteen million five hundred ninety thousand
26 dollars for the period January first, two thousand eight through March
27 thirty-first, two thousand eight, less the amount of funds available for
28 allocations for rate adjustments for workforce training programs for
29 payments by state governmental agencies for inpatient hospital services.
30 (f) Funds shall be accumulated and transferred from as follows:
31 (i) from the pool for the period January first, nineteen hundred nine-
32 ty-seven through December thirty-first, nineteen hundred ninety-seven,
33 (A) thirty-four million six hundred thousand dollars shall be trans-
34 ferred to funds reserved and accumulated pursuant to paragraph (b) of
35 subdivision nineteen of section twenty-eight hundred seven-c of this
36 article, and (B) eighty-two million dollars shall be transferred and
37 deposited and credited to the credit of the state general fund medical
38 assistance local assistance account;
39 (ii) from the pool for the period January first, nineteen hundred
40 ninety-eight through December thirty-first, nineteen hundred ninety-
41 eight, eighty-two million dollars shall be transferred and deposited and
42 credited to the credit of the state general fund medical assistance
43 local assistance account;
44 (iii) from the pool for the period January first, nineteen hundred
45 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
46 eighty-two million dollars shall be transferred and deposited and cred-
47 ited to the credit of the state general fund medical assistance local
48 assistance account;
49 (iv) from the pool or the health care reform act (HCRA) resources
50 fund, whichever is applicable, for the period January first, two thou-
51 sand through December thirty-first, two thousand four, eighty-two
52 million dollars annually, and for the period January first, two thousand
53 five through December thirty-first, two thousand five, eighty-two
54 million dollars, and for the period January first, two thousand six
55 through December thirty-first, two thousand six, eighty-two million
56 dollars, and for the period January first, two thousand seven through
S. 2108--C 15 A. 4308--C
1 [June thirtieth] December thirty-first, two thousand seven, [forty-one]
2 eighty-two million dollars, and for the period January first, two thou-
3 sand eight through March thirty-first, two thousand eight, twenty
4 million five hundred thousand dollars shall be deposited by the commis-
5 sioner, and the state comptroller is hereby authorized and directed to
6 receive for deposit to the credit of the state special revenue fund -
7 other, HCRA transfer fund, medical assistance account [or any successor
8 fund or account].
9 (g) Funds shall be transferred to primary health care services pools
10 created by the commissioner, and shall be available, including income
11 from invested funds, for distributions in accordance with former section
12 twenty-eight hundred seven-bb of this article from the respective health
13 care initiatives pools for the following periods in the following
14 percentage amounts of funds remaining after allocations in accordance
15 with paragraphs (a) through (f) of this subdivision:
16 (i) from the pool for the period January first, nineteen hundred nine-
17 ty-seven through December thirty-first, nineteen hundred ninety-seven,
18 fifteen and eighty-seven-hundredths percent;
19 (ii) from the pool for the period January first, nineteen hundred
20 ninety-eight through December thirty-first, nineteen hundred ninety-
21 eight, fifteen and eighty-seven-hundredths percent; and
22 (iii) from the pool for the period January first, nineteen hundred
23 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
24 sixteen and thirteen-hundredths percent.
25 (h) Funds shall be reserved and accumulated from year to year by the
26 commissioner and shall be available, including income from invested
27 funds, for purposes of primary care education and training pursuant to
28 article nine of this chapter from the respective health care initiatives
29 pools established for the following periods in the following percentage
30 amounts of funds remaining after allocations in accordance with para-
31 graphs (a) through (f) of this subdivision and shall be available for
32 distributions as follows:
33 (i) funds shall be reserved and accumulated:
34 (A) from the pool for the period January first, nineteen hundred nine-
35 ty-seven through December thirty-first, nineteen hundred ninety-seven,
36 six and thirty-five-hundredths percent;
37 (B) from the pool for the period January first, nineteen hundred nine-
38 ty-eight through December thirty-first, nineteen hundred ninety-eight,
39 six and thirty-five-hundredths percent; and
40 (C) from the pool for the period January first, nineteen hundred nine-
41 ty-nine through December thirty-first, nineteen hundred ninety-nine, six
42 and forty-five-hundredths percent;
43 (ii) funds shall be available for distributions including income from
44 invested funds as follows:
45 (A) for purposes of the primary care physician loan repayment program
46 in accordance with section nine hundred three of this chapter, up to
47 five million dollars on an annualized basis;
48 (B) for purposes of the primary care practitioner scholarship program
49 in accordance with section nine hundred four of this chapter, up to two
50 million dollars on an annualized basis;
51 (C) for purposes of minority participation in medical education grants
52 in accordance with section nine hundred six of this chapter, up to one
53 million dollars on an annualized basis; and
54 (D) provided, however, that the commissioner may reallocate any funds
55 remaining or unallocated for distributions for the primary care practi-
S. 2108--C 16 A. 4308--C
1 tioner scholarship program in accordance with section nine hundred four
2 of this chapter.
3 (i) Funds shall be reserved and accumulated from year to year and
4 shall be available, including income from invested funds, for distrib-
5 utions in accordance with section twenty-nine hundred fifty-two and
6 section twenty-nine hundred fifty-eight of this chapter for rural health
7 care delivery development and rural health care access development,
8 respectively, from the respective health care initiatives pools or the
9 health care reform act (HCRA) resources fund, whichever is applicable,
10 for the following periods in the following percentage amounts of funds
11 remaining after allocations in accordance with paragraphs (a) through
12 (f) of this subdivision, and for periods on and after January first, two
13 thousand, in the following amounts:
14 (i) from the pool for the period January first, nineteen hundred nine-
15 ty-seven through December thirty-first, nineteen hundred ninety-seven,
16 thirteen and forty-nine-hundredths percent;
17 (ii) from the pool for the period January first, nineteen hundred
18 ninety-eight through December thirty-first, nineteen hundred ninety-
19 eight, thirteen and forty-nine-hundredths percent;
20 (iii) from the pool for the period January first, nineteen hundred
21 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
22 thirteen and seventy-one-hundredths percent;
23 (iv) from the pool for the periods January first, two thousand through
24 December thirty-first, two thousand two, seventeen million dollars annu-
25 ally, and for the period January first, two thousand three through
26 December thirty-first, two thousand three, up to fifteen million eight
27 hundred fifty thousand dollars;
28 (v) from the pool or the health care reform act (HCRA) resources fund,
29 whichever is applicable, for the period January first, two thousand four
30 through December thirty-first, two thousand four, up to fifteen million
31 eight hundred fifty thousand dollars, and for the period January first,
32 two thousand five through December thirty-first, two thousand five, up
33 to nineteen million two hundred thousand dollars, and for the period
34 January first, two thousand six through December thirty-first, two thou-
35 sand six, up to nineteen million two hundred thousand dollars, [and] for
36 the period January first, two thousand seven through [June thirtieth]
37 December thirty-first, two thousand seven, up to [eight] eighteen
38 million [six] one hundred fifty thousand dollars, and for the period
39 January first, two thousand eight through March thirty-first, two thou-
40 sand eight, up to four million five hundred thirty-eight thousand
41 dollars; [and
42 (vi) if funds accumulated for distributions pursuant to sections twen-
43 ty-nine hundred fifty-two and twenty-nine hundred fifty-eight of this
44 chapter are insufficient to meet the funding amounts established pursu-
45 ant to subparagraphs (iv) and (v) of this paragraph, the commissioner or
46 the state comptroller, as applicable, is authorized to transfer funds
47 accumulated pursuant to section twenty-eight hundred seven-v of this
48 article to the health care initiatives pool to fully fund the amounts
49 specified in subparagraph (iv) of this paragraph; provided however, the
50 provisions of this subparagraph shall only be effective contingent upon
51 meeting all funding amounts established pursuant to paragraphs (a), (b),
52 (c), (d), (e), (f), (l), (m), (n), (q) and (r) of subdivision one of
53 section twenty-eight hundred seven-v of this article, and paragraph (a)
54 of this subdivision.]
55 (j) Funds shall be reserved and accumulated from year to year and
56 shall be available, including income from invested funds, for purposes
S. 2108--C 17 A. 4308--C
1 of distributions related to health information and health care quality
2 improvement pursuant to former section twenty-eight hundred seven-n of
3 this article from the respective health care initiatives pools estab-
4 lished for the following periods in the following percentage amounts of
5 funds remaining after allocations in accordance with paragraphs (a)
6 through (f) of this subdivision:
7 (i) from the pool for the period January first, nineteen hundred nine-
8 ty-seven through December thirty-first, nineteen hundred ninety-seven,
9 six and thirty-five-hundredths percent;
10 (ii) from the pool for the period January first, nineteen hundred
11 ninety-eight through December thirty-first, nineteen hundred ninety-
12 eight, six and thirty-five-hundredths percent; and
13 (iii) from the pool for the period January first, nineteen hundred
14 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
15 six and forty-five-hundredths percent.
16 (k) Funds shall be reserved and accumulated from year to year and
17 shall be available, including income from invested funds, for allo-
18 cations and distributions in accordance with section twenty-eight
19 hundred seven-p of this article for diagnostic and treatment center
20 uncompensated care from the respective health care initiatives pools or
21 the health care reform act (HCRA) resources fund, whichever is applica-
22 ble, for the following periods in the following percentage amounts of
23 funds remaining after allocations in accordance with paragraphs (a)
24 through (f) of this subdivision, and for periods on and after January
25 first, two thousand, in the following amounts:
26 (i) from the pool for the period January first, nineteen hundred nine-
27 ty-seven through December thirty-first, nineteen hundred ninety-seven,
28 thirty-eight and one-tenth percent;
29 (ii) from the pool for the period January first, nineteen hundred
30 ninety-eight through December thirty-first, nineteen hundred ninety-
31 eight, thirty-eight and one-tenth percent;
32 (iii) from the pool for the period January first, nineteen hundred
33 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
34 thirty-eight and seventy-one-hundredths percent;
35 (iv) from the pool for the periods January first, two thousand through
36 December thirty-first, two thousand two, forty-eight million dollars
37 annually, and for the period January first, two thousand three through
38 June thirtieth, two thousand three, twenty-four million dollars;
39 (v) (A) from the pool or the health care reform act (HCRA) resources
40 fund, whichever is applicable, for the period July first, two thousand
41 three through December thirty-first, two thousand three, up to six
42 million dollars, for the period January first, two thousand four through
43 December thirty-first, two thousand six, up to twelve million dollars
44 annually, [and] for the period January first, two thousand seven through
45 [June thirtieth] December thirty-first, two thousand seven, up to [six]
46 forty-eight million dollars, and for the period January first, two thou-
47 sand eight through March thirty-first, two thousand eight, up to twelve
48 million dollars; [provided that if federal financial participation is
49 not available for rate adjustments made pursuant to section twenty-eight
50 hundred seven-p of this article then the foregoing amounts shall be
51 increased to the following: for the period July first, two thousand
52 three through December thirty-first, two thousand three, twenty-four
53 million dollars, for the period January first, two thousand four through
54 December thirty-first, two thousand six, forty-eight million dollars
55 annually, and for the period January first, two thousand seven through
56 June thirtieth, two thousand seven, twenty-four million dollars;]
S. 2108--C 18 A. 4308--C
1 (B) from the [pool] health care reform act (HCRA) resources fund for
2 the period January first, two thousand six through December thirty-
3 first, two thousand six, an additional seven million five hundred thou-
4 sand dollars [and], for the period January first, two thousand seven
5 through [June thirtieth] December thirty-first, two thousand seven, an
6 additional [three] seven million [seven] five hundred [fifty] thousand
7 dollars, and for the period January first, two thousand eight through
8 March thirty-first, two thousand eight, an additional one million eight
9 hundred seventy-five thousand dollars, for voluntary non-profit diagnos-
10 tic and treatment center uncompensated care in accordance with subdivi-
11 sion four-c of section twenty-eight hundred seven-p of this article; and
12 (vi) [if funds accumulated for distributions pursuant to section twen-
13 ty-eight hundred seven-p of this article are insufficient to meet the
14 funding amounts established pursuant to subparagraph (iv) of this para-
15 graph, the commissioner or the state comptroller, as applicable, is
16 authorized to transfer funds accumulated pursuant to section twenty-
17 eight hundred seven-v of this article into the health care initiatives
18 pool to fully fund the amounts established pursuant to subparagraphs
19 (iv) and (v) of this paragraph; provided however, the provisions of this
20 subparagraph shall only be effective contingent upon meeting all funding
21 amounts established pursuant to paragraphs (a), (b), (c), (d), (e), (f),
22 (l), (m), (n), (q) and (r) of subdivision one of section twenty-eight
23 hundred seven-v of this article, and paragraph (a) of this subdivision;
24 and
25 (vii)] funds reserved and accumulated pursuant to this paragraph for
26 periods on and after July first, two thousand three, shall be deposited
27 by the commissioner, within amounts appropriated, and the state comp-
28 troller is hereby authorized and directed to receive for deposit to the
29 credit of the state special revenue funds - other, HCRA transfer fund,
30 medical assistance account [or any successor fund or account], for
31 purposes of funding the state share of rate adjustments made pursuant to
32 section twenty-eight hundred seven-p of this article, provided, however,
33 that in the event federal financial participation is not available for
34 rate adjustments made pursuant to paragraph (b) of subdivision one of
35 section twenty-eight hundred seven-p of this article, funds shall be
36 distributed pursuant to paragraph (a) of subdivision one of section
37 twenty-eight hundred seven-p of this article from the respective health
38 care initiatives pools or the health care reform act (HCRA) resources
39 fund, whichever is applicable.
40 (l) Funds shall be reserved and accumulated from year to year by the
41 commissioner and shall be available, including income from invested
42 funds, for transfer to and allocation for services and expenses for the
43 payment of benefits to recipients of drugs under the AIDS drug assist-
44 ance program (ADAP) - HIV uninsured care program as administered by
45 Health Research Incorporated from the respective health care initi-
46 atives pools or the health care reform act (HCRA) resources fund, which-
47 ever is applicable, established for the following periods in the follow-
48 ing percentage amounts of funds remaining after allocations in
49 accordance with paragraphs (a) through (f) of this subdivision, and for
50 periods on and after January first, two thousand, in the following
51 amounts:
52 (i) from the pool for the period January first, nineteen hundred nine-
53 ty-seven through December thirty-first, nineteen hundred ninety-seven,
54 nine and fifty-two-hundredths percent;
S. 2108--C 19 A. 4308--C
1 (ii) from the pool for the period January first, nineteen hundred
2 ninety-eight through December thirty-first, nineteen hundred ninety-
3 eight, nine and fifty-two-hundredths percent;
4 (iii) from the pool for the period January first, nineteen hundred
5 ninety-nine and December thirty-first, nineteen hundred ninety-nine,
6 nine and sixty-eight-hundredths percent;
7 (iv) from the pool for the periods January first, two thousand through
8 December thirty-first, two thousand two, up to twelve million dollars
9 annually, and for the period January first, two thousand three through
10 December thirty-first, two thousand three, up to forty million dollars;
11 and
12 (v) from the pool or the health care reform act (HCRA) resources fund,
13 whichever is applicable, for the periods January first, two thousand
14 four through December thirty-first, two thousand four, up to fifty-six
15 million dollars, for the period January first, two thousand five through
16 December thirty-first, two thousand six, up to sixty million dollars
17 annually, [and] for the period January first, two thousand seven through
18 [June thirtieth] December thirty-first, two thousand seven, up to [thir-
19 ty] sixty million dollars, and for the period January first, two thou-
20 sand eight through March thirty-first, two thousand eight, up to fifteen
21 million dollars.
22 (m) Funds shall be reserved and accumulated from year to year and
23 shall be available, including income from invested funds, for purposes
24 of distributions pursuant to section twenty-eight hundred seven-r of
25 this article for cancer related services from the respective health care
26 initiatives pools or the health care reform act (HCRA) resources fund,
27 whichever is applicable, established for the following periods in the
28 following percentage amounts of funds remaining after allocations in
29 accordance with paragraphs (a) through (f) of this subdivision, and for
30 periods on and after January first, two thousand, in the following
31 amounts:
32 (i) from the pool for the period January first, nineteen hundred nine-
33 ty-seven through December thirty-first, nineteen hundred ninety-seven,
34 seven and ninety-four-hundredths percent;
35 (ii) from the pool for the period January first, nineteen hundred
36 ninety-eight through December thirty-first, nineteen hundred ninety-
37 eight, seven and ninety-four-hundredths percent;
38 (iii) from the pool for the period January first, nineteen hundred
39 ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
40 and forty-five-hundredths percent;
41 (iv) from the pool for the period January first, two thousand through
42 December thirty-first, two thousand two, up to ten million dollars on an
43 annual basis;
44 (v) from the pool for the period January first, two thousand three
45 through December thirty-first, two thousand four, up to eight million
46 nine hundred fifty thousand dollars on an annual basis; [and]
47 (vi) from the pool or the health care reform act (HCRA) resources
48 fund, whichever is applicable, for the period January first, two thou-
49 sand five through December thirty-first, two thousand six, up to ten
50 million fifty thousand dollars on an annual basis, [and] for the period
51 January first, two thousand seven through [June thirtieth] December
52 thirty-first, two thousand seven, up to [five] nineteen million [twen-
53 ty-five thousand] dollars, and for the period January first, two thou-
54 sand eight through March thirty-first, two thousand eight, up to four
55 million seven hundred fifty thousand dollars.
S. 2108--C 20 A. 4308--C
1 (n) Funds shall be accumulated and transferred from the health care
2 reform act (HCRA) resources fund as follows: for the period April first,
3 two thousand seven through March thirty-first, two thousand eight, funds
4 within amounts appropriated shall be transferred and deposited and cred-
5 ited to the credit of the state special revenue funds - other, HCRA
6 transfer fund, medical assistance account, for purposes of funding the
7 state share of rate adjustments made to public and voluntary hospitals
8 in accordance with paragraphs (i) and (j) of subdivision one of section
9 twenty-eight hundred seven-c of this article.
10 2. [In the event residual funds are available after allocations have
11 been made pursuant to this section, such funds may be allocated and
12 distributed in a manner determined by the commissioner for purposes set
13 forth in subdivision one of this section, section twenty-eight hundred
14 seven-k or section twenty-eight hundred seven-m of this article.
15 3.] Notwithstanding any inconsistent provision of law, rule or regu-
16 lation, any funds accumulated in the health care initiatives pools
17 pursuant to paragraph (b) of subdivision nine of section twenty-eight
18 hundred seven-j of this article, as a result of surcharges, assessments
19 or other obligations during the periods January first, nineteen hundred
20 ninety-seven through December thirty-first, nineteen hundred ninety-
21 nine, which are unused or uncommitted for distributions pursuant to this
22 section shall be reserved and accumulated from year to year by the
23 commissioner and, within amounts appropriated, transferred and deposited
24 into the special revenue funds - other, miscellaneous special revenue
25 fund - 339, child health insurance account or any successor fund or
26 account, for purposes of distributions to implement the child health
27 insurance program established pursuant to sections twenty-five hundred
28 ten and twenty-five hundred eleven of this chapter for periods on and
29 after January first, two thousand one; provided, however, funds reserved
30 and accumulated for priority distributions pursuant to subparagraph
31 (iii) of paragraph (c) of subdivision one of this section shall not be
32 transferred and deposited into such account pursuant to this subdivi-
33 sion; and provided further, however, that any unused or uncommitted pool
34 funds accumulated and allocated pursuant to paragraph (j) of subdivision
35 one of this section shall be distributed for purposes of the health
36 information and quality improvement act of 2000.
37 [4.] 3. Revenue from distributions pursuant to this section shall not
38 be included in gross revenue received for purposes of the assessments
39 pursuant to subdivision eighteen of section twenty-eight hundred seven-c
40 of this article, subject to the provisions of paragraph (e) of subdivi-
41 sion eighteen of section twenty-eight hundred seven-c of this article,
42 and shall not be included in gross revenue received for purposes of the
43 assessments pursuant to section twenty-eight hundred seven-d of this
44 article, subject to the provisions of subdivision twelve of section
45 twenty-eight hundred seven-d of this article.
46 [5. Notwithstanding any inconsistent provision of law, the commission-
47 er may borrow from pool reserves from pools established or funded pursu-
48 ant to sections twenty-eight hundred seven-c, twenty-eight hundred
49 seven-j, twenty-eight hundred seven-k, twenty-eight hundred seven-m,
50 twenty-eight hundred seven-s and twenty-eight hundred seven-t of this
51 article and this section, and if not sufficient from pool funds
52 collected pursuant to section twenty-eight hundred seven-j of this arti-
53 cle and allocated for distributions pursuant to paragraph (b) of subdi-
54 vision nine of section twenty-eight hundred seven-j of this article, or
55 pursuant to sections twenty-eight hundred seven-s and twenty-eight
56 hundred seven-t of this article and allocated for distributions pursu-
S. 2108--C 21 A. 4308--C
1 ant to paragraphs (a) and (c) of subdivision seven of section twenty-
2 eight hundred seven-s of this article, such funds as shall be necessary,
3 not to exceed the amount projected to be available pursuant to paragraph
4 (b) of subdivision nine of section twenty-eight hundred seven-j of this
5 article, or paragraphs (a) and (c) of subdivision seven of section twen-
6 ty-eight hundred seven-s of this article, for distributions in accord-
7 ance with any of paragraphs (a) through (j) of subdivision one of this
8 section for a period and shall refund such moneys when pool funds become
9 available pursuant to paragraph (b) of subdivision nine of section twen-
10 ty-eight hundred seven-j and paragraphs (a) and (c) of subdivision
11 seven of section twenty-eight hundred seven-s of this article for such
12 purpose for such period.]
13 § 6. Section 2807-v of the public health law, as amended by section 3
14 of part B of chapter 58 of the laws of 2005, subparagraphs (vii) and
15 (viii) of paragraph (j) of subdivision 1 as amended by section 1 of part
16 D of chapter 57 of the laws of 2006, subparagraphs (vii) and (viii) of
17 subparagraph (k) of subdivision 1 as amended by section 3 of part D of
18 chapter 57 of the laws of 2006, subparagraphs (vii) and (viii) of para-
19 graph (n) of subdivision 1 as amended by section 4 of part D of chapter
20 57 of the laws of 2006, subparagraph (vii) of paragraph (o) of subdivi-
21 sion 1 as amended by section 5 of part D of chapter 57 of the laws of
22 2006, subparagraphs (iii) and (iv) of paragraph (u) of subdivision 1 as
23 amended by section 5-a of part D of chapter 57 of the laws of 2006,
24 subparagraphs (v) and (vi) of paragraph (v) of subdivision 1 as amended
25 by section 6 of part D of chapter 57 of the laws of 2006, the opening
26 paragraph of paragraph (hh) of subdivision 1 as amended by section 7 of
27 part D of chapter 57 of the laws of 2006, paragraph (jj) of subdivision
28 1 as amended by section 10-b of part D of chapter 57 of the laws of
29 2006, subparagraphs (v) and (vi) of paragraph (kk) of subdivision 1 as
30 amended by section 8 of part D of chapter 57 of the laws of 2006,
31 subparagraph (ii) of the second undesignated paragraph of paragraph (mm)
32 of subdivision 1 as separately amended by chapter 12 and section 3 of
33 part B of chapter 58 of the laws of 2005, subparagraphs (iv) and (v) of
34 the second undesignated paragraph of paragraph (mm) of subdivision 1 as
35 amended by section 9 of part D of chapter 57 of the laws of 2006, para-
36 graphs (ww) and (xx) of subdivision 1 as added by section 2 of part E of
37 chapter 63 of the laws of 2005, paragraphs (yy) and (zz) of subdivision
38 1 as added by chapter 161 of the laws of 2005, subparagraphs (ii) and
39 (iii) of paragraph (zz) of subdivision 1 as amended by section 10 of
40 part D of chapter 57 of the laws of 2006, paragraphs (aaa) and (bbb) of
41 subdivision 1 as added by section 10-c of part D of chapter 57 of the
42 laws of 2006, paragraph (ccc) of subdivision 1 as amended by section 4
43 of part C of chapter 109 of the laws of 2006, paragraph (ddd) of subdi-
44 vision 1 as added by section 10-e and paragraph (eee) of subdivision 1
45 as added by section 10-g-1 of part D of chapter 57 of the laws of 2006,
46 is amended to read as follows:
47 § 2807-v. Tobacco control and insurance initiatives pool distrib-
48 utions. 1. Funds accumulated in the tobacco control and insurance
49 initiatives pool or in the health care reform act (HCRA) resources fund
50 established pursuant to section ninety-two-dd of the state finance law,
51 whichever is applicable, including income from invested funds, shall be
52 distributed or retained by the commissioner or by the state comptroller,
53 as applicable, in accordance with the following:
54 (a) Funds shall be deposited by the commissioner, within amounts
55 appropriated, and the state comptroller is hereby authorized and
56 directed to receive for deposit to the credit of the state special
S. 2108--C 22 A. 4308--C
1 revenue funds - other, HCRA transfer fund, medicaid fraud hotline and
2 medicaid administration account, or any successor fund or account, for
3 purposes of services and expenses related to the toll-free medicaid
4 fraud hotline established pursuant to section one hundred eight of chap-
5 ter one of the laws of nineteen hundred ninety-nine from the tobacco
6 control and insurance initiatives pool established for the following
7 periods in the following amounts: four hundred thousand dollars annually
8 for the periods January first, two thousand through December thirty-
9 first, two thousand two, up to four hundred thousand dollars for the
10 period January first, two thousand three through December thirty-first,
11 two thousand three, up to four hundred thousand dollars for the period
12 January first, two thousand four through December thirty-first, two
13 thousand four, up to four hundred thousand dollars for the period Janu-
14 ary first, two thousand five through December thirty-first, two thousand
15 five, up to four hundred thousand dollars for the period January first,
16 two thousand six through December thirty-first, two thousand six, [and]
17 up to [two] four hundred thousand dollars for the period January first,
18 two thousand seven through [June thirtieth] December thirty-first, two
19 thousand seven, and up to one hundred thousand dollars for the period
20 January first, two thousand eight through March thirty-first, two thou-
21 sand eight.
22 (b) Funds shall be reserved and accumulated from year to year and
23 shall be available, including income from invested funds, for purposes
24 of payment of audits or audit contracts necessary to determine payor and
25 provider compliance with requirements set forth in sections twenty-eight
26 hundred seven-j, twenty-eight hundred seven-s and twenty-eight hundred
27 seven-t of this article and hospital compliance with paragraph six of
28 subdivision (a) of section 405.4 of title 10 of the official compilation
29 of codes, rules and regulations of the state of New York in accordance
30 with subdivision nine of section twenty-eight hundred three of this
31 article from the tobacco control and insurance initiatives pool estab-
32 lished for the following periods in the following amounts: five million
33 six hundred thousand dollars annually for the periods January first, two
34 thousand through December thirty-first, two thousand two, up to five
35 million dollars for the period January first, two thousand three through
36 December thirty-first, two thousand three, up to five million dollars
37 for the period January first, two thousand four through December thir-
38 ty-first, two thousand four, up to five million dollars for the period
39 January first, two thousand five through December thirty first, two
40 thousand five, up to five million dollars for the period January first,
41 two thousand six through December thirty-first, two thousand six, [and]
42 up to [two] seven million [five] eight hundred thousand dollars for the
43 period January first, two thousand seven through [June thirtieth] Decem-
44 ber thirty-first, two thousand seven, and up to one million nine hundred
45 fifty thousand dollars for the period January first, two thousand eight
46 through March thirty-first, two thousand eight.
47 (c) Funds shall be deposited by the commissioner, within amounts
48 appropriated, and the state comptroller is hereby authorized and
49 directed to receive for deposit to the credit of the state special
50 revenue funds - other, HCRA transfer fund, enhanced community services
51 account, or any successor fund or account, for mental health services
52 programs for case management services for adults and children; supported
53 housing; home and community based waiver services; family based treat-
54 ment; family support services; mobile mental health teams; transitional
55 housing; and community oversight, established pursuant to articles seven
56 and forty-one of the mental hygiene law and subdivision nine of section
S. 2108--C 23 A. 4308--C
1 three hundred sixty-six of the social services law; and for comprehen-
2 sive care centers for eating disorders pursuant to section twenty-seven
3 hundred ninety-nine-l of this chapter, provided however that, for such
4 centers, funds in the amount of five hundred thousand dollars on an
5 annualized basis shall be transferred from the enhanced community
6 services account, or any successor fund or account, and deposited into
7 the fund established by section ninety-five-e of the state finance law;
8 from the tobacco control and insurance initiatives pool established for
9 the following periods in the following amounts:
10 (i) forty-eight million dollars to be reserved, to be retained or for
11 distribution pursuant to a chapter of the laws of two thousand, for the
12 period January first, two thousand through December thirty-first, two
13 thousand;
14 (ii) eighty-seven million dollars to be reserved, to be retained or
15 for distribution pursuant to a chapter of the laws of two thousand one,
16 for the period January first, two thousand one through December thirty-
17 first, two thousand one;
18 (iii) eighty-seven million dollars to be reserved, to be retained or
19 for distribution pursuant to a chapter of the laws of two thousand two,
20 for the period January first, two thousand two through December thirty-
21 first, two thousand two;
22 (iv) eighty-eight million dollars to be reserved, to be retained or
23 for distribution pursuant to a chapter of the laws of two thousand
24 three, for the period January first, two thousand three through December
25 thirty-first, two thousand three;
26 (v) eighty-eight million dollars, plus five hundred thousand dollars,
27 to be reserved, to be retained or for distribution pursuant to a chapter
28 of the laws of two thousand four, and pursuant to section twenty-seven
29 hundred ninety-nine-l of this chapter, for the period January first, two
30 thousand four through December thirty-first, two thousand four;
31 (vi) eighty-eight million dollars, plus five hundred thousand dollars,
32 to be reserved, to be retained or for distribution pursuant to a chapter
33 of the laws of two thousand five, and pursuant to section twenty-seven
34 hundred ninety-nine-l of this chapter, for the period January first, two
35 thousand five through December thirty-first, two thousand five;
36 (vii) eighty-eight million dollars, plus five hundred thousand
37 dollars, to be reserved, to be retained or for distribution pursuant to
38 a chapter of the laws of two thousand six, and pursuant to section twen-
39 ty-seven hundred ninety-nine-l of this chapter, for the period January
40 first, two thousand six through December thirty-first, two thousand six;
41 [and]
42 (viii) [forty-four] eighty-six million four hundred thousand dollars,
43 plus [two] five hundred [fifty] thousand dollars, to be reserved, to be
44 retained or for distribution pursuant to a chapter of the laws of two
45 thousand seven and pursuant to section twenty-seven hundred
46 ninety-nine-l of this chapter, for the period January first, two thou-
47 sand seven through [June thirtieth] December thirty-first, two thousand
48 seven[.]; and
49 (ix) twenty-two million nine hundred thirteen thousand dollars, plus
50 one hundred twenty-five thousand dollars, to be reserved, to be retained
51 or for distribution pursuant to a chapter of the laws of two thousand
52 eight and pursuant to section twenty-seven hundred ninety-nine-1 of this
53 chapter, for the period January first, two thousand eight through March
54 thirty-first, two thousand eight.
55 (d) Funds shall be deposited by the commissioner, within amounts
56 appropriated, and the state comptroller is hereby authorized and
S. 2108--C 24 A. 4308--C
1 directed to receive for deposit to the credit of the state special
2 revenue funds - other, HCRA transfer fund, medical assistance account,
3 or any successor fund or account, for purposes of funding the state
4 share of services and expenses related to the family health plus program
5 including up to two and one-half million dollars annually for the period
6 January first, two thousand through December thirty-first, two thousand
7 two, for administration and marketing costs associated with such program
8 established pursuant to clause (A) of subparagraph (v) of paragraph (a)
9 of subdivision two of section three hundred sixty-nine-ee of the social
10 services law from the tobacco control and insurance initiatives pool
11 established for the following periods in the following amounts:
12 (i) three million five hundred thousand dollars for the period January
13 first, two thousand through December thirty-first, two thousand;
14 (ii) twenty-seven million dollars for the period January first, two
15 thousand one through December thirty-first, two thousand one; and
16 (iii) fifty-seven million dollars for the period January first, two
17 thousand two through December thirty-first, two thousand two.
18 (e) Funds shall be deposited by the commissioner, within amounts
19 appropriated, and the state comptroller is hereby authorized and
20 directed to receive for deposit to the credit of the state special
21 revenue funds - other, HCRA transfer fund, medical assistance account,
22 or any successor fund or account, for purposes of funding the state
23 share of services and expenses related to the family health plus program
24 including up to two and one-half million dollars annually for the period
25 January first, two thousand through December thirty-first, two thousand
26 two for administration and marketing costs associated with such program
27 established pursuant to clause (B) of subparagraph (v) of paragraph (a)
28 of subdivision two of section three hundred sixty-nine-ee of the social
29 services law from the tobacco control and insurance initiatives pool
30 established for the following periods in the following amounts:
31 (i) two million five hundred thousand dollars for the period January
32 first, two thousand through December thirty-first, two thousand;
33 (ii) thirty million five hundred thousand dollars for the period Janu-
34 ary first, two thousand one through December thirty-first, two thousand
35 one; and
36 (iii) sixty-six million dollars for the period January first, two
37 thousand two through December thirty-first, two thousand two.
38 (f) Funds shall be deposited by the commissioner, within amounts
39 appropriated, and the state comptroller is hereby authorized and
40 directed to receive for deposit to the credit of the state special
41 revenue funds - other, HCRA transfer fund, medicaid fraud hotline and
42 medicaid administration account, or any successor fund or account, for
43 purposes of payment of administrative expenses of the department related
44 to the family health plus program established pursuant to section three
45 hundred sixty-nine-ee of the social services law from the tobacco
46 control and insurance initiatives pool established for the following
47 periods in the following amounts: five hundred thousand dollars on an
48 annual basis for the periods January first, two thousand through Decem-
49 ber thirty-first, two thousand six, [and two] five hundred [fifty] thou-
50 sand dollars for the period January first, two thousand seven through
51 [June thirtieth] December thirty-first, two thousand seven, and one
52 hundred twenty-five thousand dollars for the period January first, two
53 thousand eight through March thirty-first, two thousand eight.
54 (g) Funds shall be reserved and accumulated from year to year and
55 shall be available, including income from invested funds, [contingent
56 upon meeting all funding amounts established pursuant to paragraphs (a),
S. 2108--C 25 A. 4308--C
1 (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r) and (s) of this
2 subdivision, paragraph (a) of subdivision nine of section twenty-eight
3 hundred seven-j of this article, and paragraphs (a), (i) and (k) of
4 subdivision one of section twenty-eight hundred seven-l of this article]
5 for purposes of services and expenses related to the health maintenance
6 organization direct pay market program established pursuant to sections
7 forty-three hundred twenty-one-a and forty-three hundred twenty-two-a of
8 the insurance law from the tobacco control and insurance initiatives
9 pool established for the following periods in the following amounts:
10 (i) up to thirty-five million dollars for the period January first,
11 two thousand through December thirty-first, two thousand of which fifty
12 percentum shall be allocated to the program pursuant to section four
13 thousand three hundred twenty-one-a of the insurance law and fifty
14 percentum to the program pursuant to section four thousand three hundred
15 twenty-two-a of the insurance law;
16 (ii) up to thirty-six million dollars for the period January first,
17 two thousand one through December thirty-first, two thousand one of
18 which fifty percentum shall be allocated to the program pursuant to
19 section four thousand three hundred twenty-one-a of the insurance law
20 and fifty percentum to the program pursuant to section four thousand
21 three hundred twenty-two-a of the insurance law;
22 (iii) up to thirty-nine million dollars for the period January first,
23 two thousand two through December thirty-first, two thousand two of
24 which fifty percentum shall be allocated to the program pursuant to
25 section four thousand three hundred twenty-one-a of the insurance law
26 and fifty percentum to the program pursuant to section four thousand
27 three hundred twenty-two-a of the insurance law;
28 (iv) up to forty million dollars for the period January first, two
29 thousand three through December thirty-first, two thousand three of
30 which fifty percentum shall be allocated to the program pursuant to
31 section four thousand three hundred twenty-one-a of the insurance law
32 and fifty percentum to the program pursuant to section four thousand
33 three hundred twenty-two-a of the insurance law;
34 (v) up to forty million dollars for the period January first, two
35 thousand four through December thirty-first, two thousand four of which
36 fifty percentum shall be allocated to the program pursuant to section
37 four thousand three hundred twenty-one-a of the insurance law and fifty
38 percentum to the program pursuant to section four thousand three hundred
39 twenty-two-a of the insurance law;
40 (vi) up to forty million dollars for the period January first, two
41 thousand five through December thirty-first, two thousand five of which
42 fifty percentum shall be allocated to the program pursuant to section
43 four thousand three hundred twenty-one-a of the insurance law and fifty
44 percentum to the program pursuant to section four thousand three hundred
45 twenty-two-a of the insurance law;
46 (vii) up to forty million dollars for the period January first, two
47 thousand six through December thirty-first, two thousand six of which
48 fifty percentum shall be allocated to the program pursuant to section
49 four thousand three hundred twenty-one-a of the insurance law and fifty
50 percentum shall be allocated to the program pursuant to section four
51 thousand three hundred twenty-two-a of the insurance law; [and]
52 (viii) up to [twenty] forty million dollars for the period January
53 first, two thousand seven through [June thirtieth] December
54 thirty-first, two thousand seven of which fifty percentum shall be allo-
55 cated to the program pursuant to section four thousand three hundred
56 twenty-one-a of the insurance law and fifty percentum shall be allocated
S. 2108--C 26 A. 4308--C
1 to the program pursuant to section four thousand three hundred twenty-
2 two-a of the insurance law[.]; and
3 (ix) up to ten million dollars for the period January first, two thou-
4 sand eight through March thirty-first, two thousand eight of which fifty
5 per centum shall be allocated to the program pursuant to section four
6 thousand three hundred twenty-one-a of the insurance law and fifty per
7 centum shall be allocated to the program pursuant to section four thou-
8 sand three hundred twenty-two-a of the insurance law.
9 (h) Funds shall be reserved and accumulated from year to year and
10 shall be available, including income from invested funds, [contingent
11 upon meeting all funding amounts established pursuant to paragraphs (a),
12 (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r) and (s) of this
13 subdivision, paragraph (a) of subdivision nine of section twenty-eight
14 hundred seven-j of this article, and paragraphs (a), (i) and (k) of
15 subdivision one of section twenty-eight hundred seven-l of this article]
16 for purposes of services and expenses related to the healthy New York
17 individual program established pursuant to sections four thousand three
18 hundred twenty-six and four thousand three hundred twenty-seven of the
19 insurance law from the tobacco control and insurance initiatives pool
20 established for the following periods in the following amounts:
21 (i) up to six million dollars for the period January first, two thou-
22 sand one through December thirty-first, two thousand one;
23 (ii) up to twenty-nine million dollars for the period January first,
24 two thousand two through December thirty-first, two thousand two;
25 (iii) up to five million one hundred thousand dollars for the period
26 January first, two thousand three through December thirty-first, two
27 thousand three;
28 (iv) up to twenty-four million six hundred thousand dollars for the
29 period January first, two thousand four through December thirty-first,
30 two thousand four; and
31 (v) up to thirty-four million six hundred thousand dollars for the
32 period January first, two thousand five through December thirty-first,
33 two thousand five;
34 (vi) up to fifty-four million eight hundred thousand dollars for the
35 period January first, two thousand six through December thirty-first,
36 two thousand six; and
37 (vii) up to [forty-two] sixty-one million [six] seven hundred thousand
38 dollars for the period January first, two thousand seven through [June
39 thirtieth] December thirty-first, two thousand seven[.]; and
40 (viii) up to fifteen million four hundred twenty-five thousand dollars
41 for the period January first, two thousand eight through March thirty-
42 first, two thousand eight.
43 (i) Funds shall be reserved and accumulated from year to year and
44 shall be available, including income from invested funds, [contingent
45 upon meeting all funding amounts established pursuant to paragraphs (a),
46 (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r) and (s) of this
47 subdivision, paragraph (a) of subdivision nine of section twenty-eight
48 hundred seven-j of this article, and paragraphs (a), (i) and (k) of
49 subdivision one of section twenty-eight hundred seven-l of this article]
50 for purposes of services and expenses related to the healthy New York
51 group program established pursuant to sections four thousand three
52 hundred twenty-six and four thousand three hundred twenty-seven of the
53 insurance law from the tobacco control and insurance initiatives pool
54 established for the following periods in the following amounts:
55 (i) up to thirty-four million dollars for the period January first,
56 two thousand one through December thirty-first, two thousand one;
S. 2108--C 27 A. 4308--C
1 (ii) up to seventy-seven million dollars for the period January first,
2 two thousand two through December thirty-first, two thousand two;
3 (iii) up to ten million five hundred thousand dollars for the period
4 January first, two thousand three through December thirty-first, two
5 thousand three;
6 (iv) up to twenty-four million six hundred thousand dollars for the
7 period January first, two thousand four through December thirty-first,
8 two thousand four; and
9 (v) up to thirty-four million six hundred thousand dollars for the
10 period January first, two thousand five through December thirty-first,
11 two thousand five;
12 (vi) up to fifty-four million eight hundred thousand dollars for the
13 period January first, two thousand six through December thirty-first,
14 two thousand six; [and]
15 (vii) up to [forty-two] sixty-one million [six] seven hundred thousand
16 dollars for the period January first, two thousand seven through [June
17 thirtieth] December thirty-first, two thousand seven[.]; and
18 (viii) up to fifteen million four hundred twenty-five thousand dollars
19 for the period January first, two thousand eight through March thirty-
20 first, two thousand eight.
21 (i-1) Notwithstanding the provisions of paragraphs (h) and (i) of this
22 subdivision, the commissioner shall reserve and accumulate up to two
23 million five hundred thousand dollars annually for the periods January
24 first, two thousand four through December thirty-first, two thousand six
25 [and] one million [two] four hundred [fifty] thousand dollars for the
26 period January first, two thousand seven through [June thirtieth] Decem-
27 ber thirty-first, two thousand seven, and three hundred fifty thousand
28 dollars for the period January first, two thousand eight through March
29 thirty-first, two thousand eight from funds otherwise available for
30 distribution under such paragraphs for the services and expenses related
31 to the pilot program for entertainment industry employees included in
32 subsection (b) of section one thousand one hundred twenty-two of the
33 insurance law, and an additional seven hundred thousand dollars annually
34 for the periods January first, two thousand four through December thir-
35 ty-first, two thousand six, [and] an additional three hundred thousand
36 dollars for the period January first, two thousand seven through June
37 thirtieth, two thousand seven for services and expenses related to the
38 pilot program for displaced workers included in subsection (c) of
39 section one thousand one hundred twenty-two of the insurance law.
40 (j) Funds shall be reserved and accumulated from year to year and
41 shall be available, including income from invested funds, [contingent
42 upon meeting all funding amounts established pursuant to paragraphs (a),
43 (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r) and (s) of this
44 subdivision, paragraph (a) of subdivision nine of section twenty-eight
45 hundred seven-j of this article, and paragraphs (a), (i) and (k) of
46 subdivision one of section twenty-eight hundred seven-l of this article]
47 for purposes of services and expenses related to the tobacco use
48 prevention and control program established pursuant to sections thirteen
49 hundred ninety-nine-ii and thirteen hundred ninety-nine-jj of this chap-
50 ter, from the tobacco control and insurance initiatives pool established
51 for the following periods in the following amounts:
52 (i) up to thirty million dollars for the period January first, two
53 thousand through December thirty-first, two thousand;
54 (ii) up to forty million dollars for the period January first, two
55 thousand one through December thirty-first, two thousand one;
S. 2108--C 28 A. 4308--C
1 (iii) up to forty million dollars for the period January first, two
2 thousand two through December thirty-first, two thousand two;
3 (iv) up to thirty-six million nine hundred fifty thousand dollars for
4 the period January first, two thousand three through December thirty-
5 first, two thousand three;
6 (v) up to thirty-six million nine hundred fifty thousand dollars for
7 the period January first, two thousand four through December thirty-
8 first, two thousand four;
9 (vi) up to forty million six hundred thousand dollars for the period
10 January first, two thousand five through December thirty-first, two
11 thousand five;
12 (vii) up to eighty-one million nine hundred thousand dollars for the
13 period January first, two thousand six through December thirty-first,
14 two thousand six, provided, however, that within amounts appropriated, a
15 portion of such funds may be transferred to the Roswell Park Cancer
16 Institute Corporation to support costs associated with cancer research;
17 [and]
18 (viii) up to [forty-seven] ninety-four million [eight] one hundred
19 fifty thousand dollars for the period January first, two thousand seven
20 through [June thirtieth] December thirty-first, two thousand seven,
21 provided, however, that within amounts appropriated, a portion of such
22 funds may be transferred to the Roswell Park Cancer Institute Corpo-
23 ration to support costs associated with cancer research[.]; and
24 (ix) up to twenty-three million five hundred thirty-eight thousand
25 dollars for the period January first, two thousand eight through March
26 thirty-first, two thousand eight.
27 (k) Funds shall be deposited by the commissioner, within amounts
28 appropriated, and the state comptroller is hereby authorized and
29 directed to receive for deposit to the credit of the state special
30 revenue fund - other, HCRA transfer fund, health care services account,
31 or any successor fund or account, [contingent upon meeting all funding
32 amounts established pursuant to paragraphs (a), (b), (c), (d), (e), (f),
33 (l), (m), (n), (p), (q), (r) and (s) of this subdivision, paragraph (a)
34 of subdivision nine of section twenty-eight hundred seven-j of this
35 article, and paragraphs (a), (i) and (k) of subdivision one of section
36 twenty-eight hundred seven-l of this article] for purposes of services
37 and expenses related to public health programs, including comprehensive
38 care centers for eating disorders pursuant to section twenty-seven
39 hundred ninety-nine-l of this chapter, provided however that, for such
40 centers, funds in the amount of five hundred thousand dollars on an
41 annualized basis shall be transferred from the health care services
42 account, or any successor fund or account, and deposited into the fund
43 established by section ninety-five-e of the state finance law, from the
44 tobacco control and insurance initiatives pool established for the
45 following periods in the following amounts:
46 (i) up to thirty-one million dollars for the period January first, two
47 thousand through December thirty-first, two thousand;
48 (ii) up to forty-one million dollars for the period January first, two
49 thousand one through December thirty-first, two thousand one;
50 (iii) up to eighty-one million dollars for the period January first,
51 two thousand two through December thirty-first, two thousand two;
52 (iv) one hundred twenty-two million five hundred thousand dollars for
53 the period January first, two thousand three through December thirty-
54 first, two thousand three;
55 (v) one hundred eight million five hundred seventy-five thousand
56 dollars, plus an additional five hundred thousand dollars, for the peri-
S. 2108--C 29 A. 4308--C
1 od January first, two thousand four through December thirty-first, two
2 thousand four;
3 (vi) ninety-one million eight hundred thousand dollars, plus an addi-
4 tional five hundred thousand dollars, for the period January first, two
5 thousand five through December thirty-first, two thousand five;
6 (vii) one hundred fifty-six million six hundred thousand dollars, plus
7 an additional five hundred thousand dollars, for the period January
8 first, two thousand six through December thirty-first, two thousand six;
9 [and]
10 (viii) [seventy-five] one hundred fifty-one million [seven] four
11 hundred thousand dollars, plus an additional [two] five hundred [fifty]
12 thousand dollars, for the period January first, two thousand seven
13 through [June thirtieth] December thirty-first, two thousand seven[.];
14 and
15 (ix) thirty-seven million eight hundred fifty thousand dollars, plus
16 an additional one hundred twenty-five thousand dollars, for the period
17 January first, two thousand eight through March thirty-first, two thou-
18 sand eight.
19 (l) Funds shall be deposited by the commissioner, within amounts
20 appropriated, and the state comptroller is hereby authorized and
21 directed to receive for deposit to the credit of the state special
22 revenue funds - other, HCRA transfer fund, medical assistance account,
23 or any successor fund or account, for purposes of funding the state
24 share of the personal care and certified home health agency rate or fee
25 increases established pursuant to subdivision three of section three
26 hundred sixty-seven-o of the social services law from the tobacco
27 control and insurance initiatives pool established for the following
28 periods in the following amounts:
29 (i) twenty-three million two hundred thousand dollars for the period
30 January first, two thousand through December thirty-first, two thousand;
31 (ii) twenty-three million two hundred thousand dollars for the period
32 January first, two thousand one through December thirty-first, two thou-
33 sand one;
34 (iii) twenty-three million two hundred thousand dollars for the period
35 January first, two thousand two through December thirty-first, two thou-
36 sand two;
37 (iv) up to sixty-five million two hundred thousand dollars for the
38 period January first, two thousand three through December thirty-first,
39 two thousand three;
40 (v) up to sixty-five million two hundred thousand dollars for the
41 period January first, two thousand four through December thirty-first,
42 two thousand four;
43 (vi) up to sixty-five million two hundred thousand dollars for the
44 period January first, two thousand five through December thirty-first,
45 two thousand five;
46 (vii) up to sixty-five million two hundred thousand dollars for the
47 period January first, two thousand six through December thirty-first,
48 two thousand six; [and]
49 (viii) up to [thirty-two] sixty-five million [six] two hundred thou-
50 sand dollars for the period January first, two thousand seven through
51 [June thirtieth] December thirty-first, two thousand seven[.]; and
52 (ix) up to sixteen million three hundred thousand dollars for the
53 period January first, two thousand eight through March thirty-first, two
54 thousand eight.
55 (m) Funds shall be deposited by the commissioner, within amounts
56 appropriated, and the state comptroller is hereby authorized and
S. 2108--C 30 A. 4308--C
1 directed to receive for deposit to the credit of the state special
2 revenue funds - other, HCRA transfer fund, medical assistance account,
3 or any successor fund or account, for purposes of funding the state
4 share of services and expenses related to home care workers insurance
5 pilot demonstration programs established pursuant to subdivision two of
6 section three hundred sixty-seven-o of the social services law from the
7 tobacco control and insurance initiatives pool established for the
8 following periods in the following amounts:
9 (i) three million eight hundred thousand dollars for the period Janu-
10 ary first, two thousand through December thirty-first, two thousand;
11 (ii) three million eight hundred thousand dollars for the period Janu-
12 ary first, two thousand one through December thirty-first, two thousand
13 one;
14 (iii) three million eight hundred thousand dollars for the period
15 January first, two thousand two through December thirty-first, two thou-
16 sand two;
17 (iv) up to three million eight hundred thousand dollars for the period
18 January first, two thousand three through December thirty-first, two
19 thousand three;
20 (v) up to three million eight hundred thousand dollars for the period
21 January first, two thousand four through December thirty-first, two
22 thousand four;
23 (vi) up to three million eight hundred thousand dollars for the period
24 January first, two thousand five through December thirty-first, two
25 thousand five;
26 (vii) up to three million eight hundred thousand dollars for the peri-
27 od January first, two thousand six through December thirty-first, two
28 thousand six; [and]
29 (viii) up to [two] three million eight hundred thousand dollars for
30 the period January first, two thousand seven through [June thirtieth]
31 December thirty-first, two thousand seven[.]; and
32 (ix) up to nine hundred fifty thousand dollars for the period January
33 first, two thousand eight through March thirty-first, two thousand
34 eight.
35 (n) Funds shall be transferred by the commissioner and shall be depos-
36 ited to the credit of the special revenue funds - other, miscellaneous
37 special revenue fund - 339, elderly pharmaceutical insurance coverage
38 program premium account authorized pursuant to the provisions of title
39 three of article two of the elder law, or any successor fund or account,
40 for funding state expenses relating to the program from the tobacco
41 control and insurance initiatives pool established for the following
42 periods in the following amounts:
43 (i) one hundred seven million dollars for the period January first,
44 two thousand through December thirty-first, two thousand;
45 (ii) one hundred sixty-four million dollars for the period January
46 first, two thousand one through December thirty-first, two thousand one;
47 (iii) three hundred twenty-two million seven hundred thousand dollars
48 for the period January first, two thousand two through December thirty-
49 first, two thousand two;
50 (iv) four hundred thirty-three million three hundred thousand dollars
51 for the period January first, two thousand three through December thir-
52 ty-first, two thousand three;
53 (v) five hundred four million one hundred fifty thousand dollars for
54 the period January first, two thousand four through December thirty-
55 first, two thousand four;
S. 2108--C 31 A. 4308--C
1 (vi) five hundred sixty-six million eight hundred thousand dollars for
2 the period January first, two thousand five through December thirty-
3 first, two thousand five;
4 (vii) six hundred three million one hundred fifty thousand dollars for
5 the period January first, two thousand six through December thirty-
6 first, two thousand six; [and]
7 (viii) [three hundred thirty] six hundred sixty million [four] eight
8 hundred thousand dollars for the period January first, two thousand
9 seven through [June thirtieth] December thirty-first, two thousand
10 seven[.]; and
11 (ix) one hundred sixty-five million two hundred thousand dollars for
12 the period January first, two thousand eight through March thirty-first,
13 two thousand eight.
14 (o) Funds shall be reserved and accumulated [contingent upon meeting
15 all funding amounts established pursuant to paragraphs (a), (b), (c),
16 (d), (e), (f), (l), (m), (n), (p), (q), (r) and (s) of this subdivision,
17 paragraph (a) of subdivision nine of section twenty-eight hundred
18 seven-j of this article, and paragraphs (a), (i) and (k) of subdivision
19 one of section twenty-eight hundred seven-l of this article] and shall
20 be transferred to the Roswell Park Cancer Institute Corporation, from
21 the tobacco control and insurance initiatives pool established for the
22 following periods in the following amounts:
23 (i) up to ninety million dollars for the period January first, two
24 thousand through December thirty-first, two thousand;
25 (ii) up to sixty million dollars for the period January first, two
26 thousand one through December thirty-first, two thousand one;
27 (iii) up to eighty-five million dollars for the period January first,
28 two thousand two through December thirty-first, two thousand two;
29 (iv) eighty-five million two hundred fifty thousand dollars for the
30 period January first, two thousand three through December thirty-first,
31 two thousand three;
32 (v) seventy-eight million dollars for the period January first, two
33 thousand four through December thirty-first, two thousand four;
34 (vi) seventy-eight million dollars for the period January first, two
35 thousand five through December thirty-first, two thousand five;
36 (vii) ninety-one million dollars for the period January first, two
37 thousand six through December thirty-first, two thousand six; [and]
38 (viii) [thirty-nine] seventy-eight million dollars for the period
39 January first, two thousand seven through [June thirtieth] December
40 thirty-first, two thousand seven[.]; and
41 (ix) nineteen million five hundred thousand dollars for the period
42 January first, two thousand eight through March thirty-first, two thou-
43 sand eight.
44 (p) Funds shall be deposited by the commissioner, within amounts
45 appropriated, and the state comptroller is hereby authorized and
46 directed to receive for deposit to the credit of the state special
47 revenue funds - other, indigent care fund - 068, indigent care account,
48 or any successor fund or account, [contingent upon meeting all funding
49 amounts established pursuant to paragraphs (a), (b), (c), (d), (e), (f),
50 (l), (m), (n), (q) and (r) of this subdivision and paragraph (a) of
51 subdivision one of section twenty-eight hundred seven-l of this article]
52 for purposes of providing a medicaid disproportionate share payment from
53 the high need indigent care adjustment pool established pursuant to
54 section twenty-eight hundred seven-w of this article, from the tobacco
55 control and insurance initiatives pool established for the following
56 periods in the following amounts:
S. 2108--C 32 A. 4308--C
1 (i) eighty-two million dollars annually for the periods January first,
2 two thousand through December thirty-first, two thousand two;
3 (ii) up to eighty-two million dollars for the period January first,
4 two thousand three through December thirty-first, two thousand three;
5 (iii) up to eighty-two million dollars for the period January first,
6 two thousand four through December thirty-first, two thousand four;
7 (iv) up to eighty-two million dollars for the period January first,
8 two thousand five through December thirty-first, two thousand five;
9 (v) up to eighty-two million dollars for the period January first, two
10 thousand six through December thirty-first, two thousand six; [and]
11 (vi) up to [forty-one] eighty-two million dollars for the period Janu-
12 ary first, two thousand seven through [June thirtieth] December thirty-
13 first, two thousand seven[.]; and
14 (vii) up to twenty million five hundred thousand dollars for the peri-
15 od January first, two thousand eight through March thirty-first, two
16 thousand eight.
17 (q) Funds shall be reserved and accumulated from year to year and
18 shall be available, including income from invested funds, for purposes
19 of providing distributions to eligible school based health centers
20 established pursuant to section eighty-eight of chapter one of the laws
21 of nineteen hundred ninety-nine [which enacted the New York Health Care
22 Reform Act of 2000], from the tobacco control and insurance initiatives
23 pool established for the following periods in the following amounts:
24 (i) seven million dollars annually for the period January first, two
25 thousand through December thirty-first, two thousand two;
26 (ii) up to seven million dollars for the period January first, two
27 thousand three through December thirty-first, two thousand three;
28 (iii) up to seven million dollars for the period January first, two
29 thousand four through December thirty-first, two thousand four;
30 (iv) up to seven million dollars for the period January first, two
31 thousand five through December thirty-first, two thousand five;
32 (v) up to seven million dollars for the period January first, two
33 thousand six through December thirty-first, two thousand six; [and]
34 (vi) up to [three] seven million [five hundred thousand] dollars for
35 the period January first, two thousand seven through [June thirtieth]
36 December thirty-first, two thousand seven[.]; and
37 (vii) up to one million seven hundred fifty thousand dollars for the
38 period January first, two thousand eight through March thirty-first, two
39 thousand eight.
40 (r) Funds shall be deposited by the commissioner within amounts appro-
41 priated, and the state comptroller is hereby authorized and directed to
42 receive for deposit to the credit of the state special revenue funds -
43 other, HCRA transfer fund, medical assistance account, or any successor
44 fund or account, for purposes of providing distributions for supplemen-
45 tary medical insurance for Medicare part B premiums, physicians
46 services, outpatient services, medical equipment, supplies and other
47 health services, from the tobacco control and insurance initiatives pool
48 established for the following periods in the following amounts:
49 (i) forty-three million dollars for the period January first, two
50 thousand through December thirty-first, two thousand;
51 (ii) sixty-one million dollars for the period January first, two thou-
52 sand one through December thirty-first, two thousand one;
53 (iii) sixty-five million dollars for the period January first, two
54 thousand two through December thirty-first, two thousand two;
S. 2108--C 33 A. 4308--C
1 (iv) sixty-seven million five hundred thousand dollars for the period
2 January first, two thousand three through December thirty-first, two
3 thousand three;
4 (v) sixty-eight million dollars for the period January first, two
5 thousand four through December thirty-first, two thousand four;
6 (vi) sixty-eight million dollars for the period January first, two
7 thousand five through December thirty-first, two thousand five;
8 (vii) sixty-eight million dollars for the period January first, two
9 thousand six through December thirty-first, two thousand six; [and]
10 (viii) [thirty-four] seventeen million five hundred thousand dollars
11 for the period January first, two thousand seven through [June thirti-
12 eth] December thirty-first, two thousand seven[.]; and
13 (ix) four million three hundred seventy-five thousand dollars for the
14 period January first, two thousand eight through March thirty-first, two
15 thousand eight.
16 (s) Funds shall be deposited by the commissioner within amounts appro-
17 priated, and the state comptroller is hereby authorized and directed to
18 receive for deposit to the credit of the state special revenue funds -
19 other, HCRA transfer fund, medical assistance account, or any successor
20 fund or account, [contingent upon meeting all funding amounts estab-
21 lished pursuant to paragraphs (a), (b), (c), (d), (e), (f), (l), (m),
22 (n), (q), and (r) of this subdivision, and paragraph (a) of subdivision
23 one of section twenty-eight hundred seven-l of this article,] for
24 purposes of providing distributions pursuant to paragraphs (s-5), (s-6)
25 [and], (s-7) and (s-8) of subdivision eleven of section twenty-eight
26 hundred seven-c of this article from the tobacco control and insurance
27 initiatives pool established for the following periods in the following
28 amounts:
29 (i) eighteen million dollars for the period January first, two thou-
30 sand through December thirty-first, two thousand;
31 (ii) twenty-four million dollars annually for the periods January
32 first, two thousand one through December thirty-first, two thousand two;
33 (iii) up to twenty-four million dollars for the period January first,
34 two thousand three through December thirty-first, two thousand three;
35 (iv) up to twenty-four million dollars for the period January first,
36 two thousand four through December thirty-first, two thousand four;
37 (v) up to twenty-four million dollars for the period January first,
38 two thousand five through December thirty-first, two thousand five;
39 (vi) up to twenty-four million dollars for the period January first,
40 two thousand six through December thirty-first, two thousand six; [and]
41 (vii) up to [six] twenty-four million dollars for the period January
42 first, two thousand seven through [March thirty-first] December thirty-
43 first, two thousand seven[.]; and
44 (viii) up to six million dollars for the period January first, two
45 thousand eight through March thirty-first, two thousand eight.
46 (t) Funds shall be reserved and accumulated from year to year by the
47 commissioner and shall be made available, including income from invested
48 funds:
49 (i) For the purpose of making grants to a state owned and operated
50 medical school which does not have a state owned and operated hospital
51 on site and available for teaching purposes. Notwithstanding sections
52 one hundred twelve and one hundred sixty-three of the state finance law,
53 such grants shall be made in the amount of up to five hundred thousand
54 dollars for the period January first, two thousand through December
55 thirty-first, two thousand;
S. 2108--C 34 A. 4308--C
1 (ii) For the purpose of making grants to medical schools pursuant to
2 section eighty-six-a of chapter one of the laws of nineteen hundred
3 ninety-nine in the sum of up to four million dollars for the period
4 January first, two thousand through December thirty-first, two thousand;
5 and
6 (iii) The funds disbursed pursuant to subparagraphs (i) and (ii) of
7 this paragraph from the tobacco control and insurance initiatives pool
8 are contingent upon meeting all funding amounts established pursuant to
9 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
10 and (s) of this subdivision, paragraph (a) of subdivision nine of
11 section twenty-eight hundred seven-j of this article, and paragraphs
12 (a), (i) and (k) of subdivision one of section twenty-eight hundred
13 seven-l of this article.
14 (u) Funds shall be deposited by the commissioner, within amounts
15 appropriated, and the state comptroller is hereby authorized and
16 directed to receive for deposit to the credit of the state special
17 revenue funds - other, HCRA transfer fund, medical assistance account,
18 or any successor fund or account, for purposes of funding the state
19 share of services and expenses related to the nursing home quality
20 improvement demonstration program established pursuant to section twen-
21 ty-eight hundred eight-d of this article from the tobacco control and
22 insurance initiatives pool established for the following periods in the
23 following amounts:
24 (i) up to twenty-five million dollars for the period beginning April
25 first, two thousand two and ending December thirty-first, two thousand
26 two, and on an annualized basis, for each annual period thereafter
27 beginning January first, two thousand three and ending December thirty-
28 first, two thousand four;
29 (ii) up to eighteen million seven hundred fifty thousand dollars for
30 the period January first, two thousand five through December thirty-
31 first, two thousand five; and
32 (iii) up to fifty-six million five hundred thousand dollars for the
33 period January first, two thousand six through December thirty-first,
34 two thousand six[; and
35 (iv) up to twenty-eight million two hundred fifty thousand dollars for
36 the period January first, two thousand seven through June thirtieth, two
37 thousand seven].
38 (v) Funds shall be transferred by the commissioner and shall be depos-
39 ited to the credit of the hospital excess liability pool created pursu-
40 ant to section eighteen of chapter two hundred sixty-six of the laws of
41 nineteen hundred eighty-six, or any successor fund or account, for
42 purposes of expenses related to the purchase of excess medical malprac-
43 tice insurance and the cost of administrating the pool, including costs
44 associated with the risk management program established pursuant to
45 section forty-two of part A of chapter one of the laws of two thousand
46 two required by paragraph (a) of subdivision one of section eighteen of
47 chapter two hundred sixty-six of the laws of nineteen hundred eighty-six
48 as may be amended from time to time, from the tobacco control and insur-
49 ance initiatives pool established for the following periods in the
50 following amounts:
51 (i) up to fifty million dollars or so much as is needed for the period
52 January first, two thousand two through December thirty-first, two thou-
53 sand two;
54 (ii) up to seventy-six million seven hundred thousand dollars for the
55 period January first, two thousand three through December thirty-first,
56 two thousand three;
S. 2108--C 35 A. 4308--C
1 (iii) up to sixty-five million dollars for the period January first,
2 two thousand four through December thirty-first, two thousand four;
3 (iv) up to sixty-five million dollars for the period January first,
4 two thousand five through December thirty-first, two thousand five;
5 (v) up to one hundred thirteen million eight hundred thousand dollars
6 for the period January first, two thousand six through December thirty-
7 first, two thousand six; [and]
8 (vi) up to [forty-eight] one hundred thirty million [eight hundred
9 thousand] dollars for the period January first, two thousand seven
10 through [June thirtieth] December thirty-first, two thousand seven[.];
11 and
12 (vii) up to thirty-two million five hundred thousand dollars for the
13 period January first, two thousand eight through March thirty-first, two
14 thousand eight.
15 (w) Funds shall be deposited by the commissioner, within amounts
16 appropriated, and the state comptroller is hereby authorized and
17 directed to receive for deposit to the credit of the state special
18 revenue funds - other, HCRA transfer fund, medical assistance account,
19 or any successor fund or account, for purposes of funding the state
20 share of the treatment of breast and cervical cancer pursuant to para-
21 graph (v) of subdivision four of section three hundred sixty-six of the
22 social services law, from the tobacco control and insurance initiatives
23 pool established for the following periods in the following amounts:
24 (i) up to four hundred fifty thousand dollars for the period January
25 first, two thousand two through December thirty-first, two thousand two;
26 (ii) up to two million one hundred thousand dollars for the period
27 January first, two thousand three through December thirty-first, two
28 thousand three;
29 (iii) up to two million one hundred thousand dollars for the period
30 January first, two thousand four through December thirty-first, two
31 thousand four;
32 (iv) up to two million one hundred thousand dollars for the period
33 January first, two thousand five through December thirty-first, two
34 thousand five;
35 (v) up to two million one hundred thousand dollars for the period
36 January first, two thousand six through December thirty-first, two thou-
37 sand six; [and]
38 (vi) up to [one] two million one hundred thousand dollars for the
39 period January first, two thousand seven through [June thirtieth] Decem-
40 ber thirty-first, two thousand seven[.]; and
41 (vii) up to five hundred twenty-five thousand dollars for the period
42 January first, two thousand eight through March thirty-first, two thou-
43 sand eight.
44 (x) Funds shall be deposited by the commissioner, within amounts
45 appropriated, and the state comptroller is hereby authorized and
46 directed to receive for deposit to the credit of the state special
47 revenue funds - other, HCRA transfer fund, medical assistance account,
48 or any successor fund or account, for purposes of funding the state
49 share of the non-public general hospital rates increases for recruitment
50 and retention of health care workers pursuant to paragraph (a) of subdi-
51 vision thirty and subdivision thirty-one of section twenty-eight hundred
52 seven-c of this article from the tobacco control and insurance initi-
53 atives pool established for the following periods in the following
54 amounts:
S. 2108--C 36 A. 4308--C
1 (i) twenty-seven million one hundred thousand dollars on an annualized
2 basis for the period January first, two thousand two through December
3 thirty-first, two thousand two;
4 (ii) fifty million eight hundred thousand dollars on an annualized
5 basis for the period January first, two thousand three through December
6 thirty-first, two thousand three;
7 (iii) sixty-nine million three hundred thousand dollars on an annual-
8 ized basis for the period January first, two thousand four through
9 December thirty-first, two thousand four;
10 (iv) sixty-nine million three hundred thousand dollars for the period
11 January first, two thousand five through December thirty-first, two
12 thousand five;
13 (v) sixty-nine million three hundred thousand dollars for the period
14 January first, two thousand six through December thirty-first, two thou-
15 sand six; [and]
16 (vi) [thirty-four] sixty-five million [six] three hundred [fifty]
17 thousand dollars for the period January first, two thousand seven
18 through [June thirtieth] December thirty-first, two thousand seven[.];
19 and
20 (vii) sixteen million three hundred twenty-five thousand dollars for
21 the period January first, two thousand eight through March thirty-first,
22 two thousand eight.
23 (y) Funds shall be reserved and accumulated from year to year and
24 shall be available, including income from invested funds, for purposes
25 of grants to public general hospitals for recruitment and retention of
26 health care workers pursuant to paragraph (b) of subdivision thirty of
27 section twenty-eight hundred seven-c of this article from the tobacco
28 control and insurance initiatives pool established for the following
29 periods in the following amounts:
30 (i) eighteen million five hundred thousand dollars on an annualized
31 basis for the period January first, two thousand two through December
32 thirty-first, two thousand two;
33 (ii) thirty-seven million four hundred thousand dollars on an annual-
34 ized basis for the period January first, two thousand three through
35 December thirty-first, two thousand three;
36 (iii) fifty-two million two hundred thousand dollars on an annualized
37 basis for the period January first, two thousand four through December
38 thirty-first, two thousand four;
39 (iv) fifty-two million two hundred thousand dollars for the period
40 January first, two thousand five through December thirty-first, two
41 thousand five;
42 (v) fifty-two million two hundred thousand dollars for the period
43 January first, two thousand six through December thirty-first, two thou-
44 sand six; [and]
45 (vi) [twenty-six] forty-nine million [one hundred thousand] dollars
46 for the period January first, two thousand seven through [June thirti-
47 eth] December thirty-first, two thousand seven;
48 (vii) twelve million two hundred fifty thousand dollars for the period
49 January first, two thousand eight through March thirty-first, two thou-
50 sand eight; and
51 (viii) provided, however, amounts pursuant to this paragraph may be
52 reduced in an amount to be approved by the director of the budget to
53 reflect amounts received from the federal government under the state's
54 1115 waiver which are directed under its terms and conditions to the
55 health workforce recruitment and retention program.
S. 2108--C 37 A. 4308--C
1 (z) Funds shall be deposited by the commissioner, within amounts
2 appropriated, and the state comptroller is hereby authorized and
3 directed to receive for deposit to the credit of the state special
4 revenue funds - other, HCRA transfer fund, medical assistance account,
5 or any successor fund or account, for purposes of funding the state
6 share of the non-public residential health care facility rate increases
7 for recruitment and retention of health care workers pursuant to para-
8 graph (a) of subdivision eighteen of section twenty-eight hundred eight
9 of this article from the tobacco control and insurance initiatives pool
10 established for the following periods in the following amounts:
11 (i) twenty-one million five hundred thousand dollars on an annualized
12 basis for the period January first, two thousand two through December
13 thirty-first, two thousand two;
14 (ii) thirty-three million three hundred thousand dollars on an annual-
15 ized basis for the period January first, two thousand three through
16 December thirty-first, two thousand three;
17 (iii) forty-six million three hundred thousand dollars on an annual-
18 ized basis for the period January first, two thousand four through
19 December thirty-first, two thousand four;
20 (iv) forty-six million three hundred thousand dollars for the period
21 January first, two thousand five through December thirty-first, two
22 thousand five;
23 (v) forty-six million three hundred thousand dollars for the period
24 January first, two thousand six through December thirty-first, two thou-
25 sand six; [and]
26 (vi) [twenty-three] thirty million [two] nine hundred thousand dollars
27 for the period January first, two thousand seven through [June thirti-
28 eth] December thirty-first, two thousand seven[.]; and
29 (vii) seven million seven hundred twenty-five thousand dollars for the
30 period January first, two thousand eight through March thirty-first, two
31 thousand eight.
32 (aa) Funds shall be reserved and accumulated from year to year and
33 shall be available, including income from invested funds, for purposes
34 of grants to public residential health care facilities for recruitment
35 and retention of health care workers pursuant to paragraph (b) of subdi-
36 vision eighteen of section twenty-eight hundred eight of this article
37 from the tobacco control and insurance initiatives pool established for
38 the following periods in the following amounts:
39 (i) seven million five hundred thousand dollars on an annualized basis
40 for the period January first, two thousand two through December thirty-
41 first, two thousand two;
42 (ii) eleven million seven hundred thousand dollars on an annualized
43 basis for the period January first, two thousand three through December
44 thirty-first, two thousand three;
45 (iii) sixteen million two hundred thousand dollars on an annualized
46 basis for the period January first, two thousand four through December
47 thirty-first, two thousand four;
48 (iv) sixteen million two hundred thousand dollars for the period Janu-
49 ary first, two thousand five through December thirty-first, two thousand
50 five;
51 (v) sixteen million two hundred thousand dollars for the period Janu-
52 ary first, two thousand six through December thirty-first, two thousand
53 six; [and]
54 (vi) [eight] ten million [one] eight hundred thousand dollars for the
55 period January first, two thousand seven through [June thirtieth] Decem-
56 ber thirty-first, two thousand seven[.]; and
S. 2108--C 38 A. 4308--C
1 (vii) two million seven hundred thousand dollars for the period Janu-
2 ary first, two thousand eight through March thirty-first, two thousand
3 eight.
4 (bb)(i) Funds shall be deposited by the commissioner, within amounts
5 appropriated, and subject to the availability of federal financial
6 participation, and the state comptroller is hereby authorized and
7 directed to receive for deposit to the credit of the state special
8 revenue funds - other, HCRA transfer fund, medical assistance account,
9 or any successor fund or account, for the purpose of supporting the
10 state share of adjustments to Medicaid rates of payment for personal
11 care services provided pursuant to paragraph (e) of subdivision two of
12 section three hundred sixty-five-a of the social services law, for local
13 social service districts which include a city with a population of over
14 one million persons and computed and distributed in accordance with
15 memorandums of understanding to be entered into between the state of New
16 York and such local social service districts for the purpose of support-
17 ing the recruitment and retention of personal care service workers or
18 any worker with direct patient care responsibility, from the tobacco
19 control and insurance initiatives pool established for the following
20 periods and the following amounts:
21 (A) forty-four million dollars, on an annualized basis, for the period
22 April first, two thousand two through December thirty-first, two thou-
23 sand two;
24 (B) seventy-four million dollars, on an annualized basis, for the
25 period January first, two thousand three through December thirty-first,
26 two thousand three;
27 (C) one hundred four million dollars, on an annualized basis, for the
28 period January first, two thousand four through December thirty-first,
29 two thousand four;
30 (D) one hundred thirty-six million dollars, on an annualized basis,
31 for the period January first, two thousand five through December thir-
32 ty-first, two thousand five;
33 (E) one hundred thirty-six million dollars, on an annualized basis,
34 for the period January first, two thousand six through December thirty-
35 first, two thousand six; [and]
36 (F) [sixty-eight] one hundred thirty-six million dollars for the peri-
37 od January first, two thousand seven through [June thirtieth] December
38 thirty-first, two thousand seven[.]; and
39 (G) thirty-four million dollars for the period January first, two
40 thousand eight through March thirty-first, two thousand eight.
41 (ii) Adjustments to Medicaid rates made pursuant to this paragraph
42 shall not, in aggregate, exceed the following amounts for the following
43 periods:
44 (A) for the period April first, two thousand two through December
45 thirty-first, two thousand two, one hundred ten million dollars;
46 (B) for the period January first, two thousand three through December
47 thirty-first, two thousand three, one hundred eighty-five million
48 dollars;
49 (C) for the period January first, two thousand four through December
50 thirty-first, two thousand four, two hundred sixty million dollars;
51 (D) for the period January first, two thousand five through December
52 thirty-first, two thousand five, three hundred forty million dollars;
53 (E) for the period January first, two thousand six through December
54 thirty-first, two thousand six, three hundred forty million dollars;
55 [and]
S. 2108--C 39 A. 4308--C
1 (F) for the period January first, two thousand seven through [June
2 thirtieth] December thirty-first, two thousand seven, [one hundred
3 seventy] three hundred forty million dollars[.]; and
4 (G) for the period January first, two thousand eight through March
5 thirty-first, two thousand eight, eighty-five million dollars.
6 (iii) Personal care service providers which have their rates adjusted
7 pursuant to this paragraph shall use such funds for the purpose of
8 recruitment and retention of non-supervisory personal care services
9 workers or any worker with direct patient care responsibility only and
10 are prohibited from using such funds for any other purpose. Each such
11 personal care services provider shall submit, at a time and in a manner
12 to be determined by the commissioner, a written certification attesting
13 that such funds will be used solely for the purpose of recruitment and
14 retention of non-supervisory personal care services workers or any work-
15 er with direct patient care responsibility. The commissioner is author-
16 ized to audit each such provider to ensure compliance with the written
17 certification required by this subdivision and shall recoup any funds
18 determined to have been used for purposes other than recruitment and
19 retention of non-supervisory personal care services workers or any work-
20 er with direct patient care responsibility. Such recoupment shall be in
21 addition to any other penalties provided by law.
22 (cc) Funds shall be deposited by the commissioner, within amounts
23 appropriated, and the state comptroller is hereby authorized and
24 directed to receive for deposit to the credit of the state special
25 revenue funds - other, HCRA transfer fund, medical assistance account,
26 or any successor fund or account, for the purpose of supporting the
27 state share of adjustments to Medicaid rates of payment for personal
28 care services provided pursuant to paragraph (e) of subdivision two of
29 section three hundred sixty-five-a of the social services law, for local
30 social service districts which shall not include a city with a popu-
31 lation of over one million persons for the purpose of supporting the
32 personal care services worker recruitment and retention program as
33 established pursuant to section three hundred sixty-seven-q of the
34 social services law, from the tobacco control and insurance initiatives
35 pool established for the following periods and the following amounts:
36 (i) two million eight hundred thousand dollars for the period April
37 first, two thousand two through December thirty-first, two thousand two;
38 (ii) five million six hundred thousand dollars, on an annualized
39 basis, for the period January first, two thousand three through December
40 thirty-first, two thousand three;
41 (iii) eight million four hundred thousand dollars, on an annualized
42 basis, for the period January first, two thousand four through December
43 thirty-first, two thousand four;
44 (iv) ten million eight hundred thousand dollars, on an annualized
45 basis, for the period January first, two thousand five through December
46 thirty-first, two thousand five;
47 (v) ten million eight hundred thousand dollars, on an annualized
48 basis, for the period January first, two thousand six through December
49 thirty-first, two thousand six; [and]
50 (vi) [five] eleven million [four] two hundred thousand dollars for the
51 period January first, two thousand seven through [June thirtieth] Decem-
52 ber thirty-first, two thousand seven[.]; and
53 (vii) two million eight hundred thousand dollars for the period Janu-
54 ary first, two thousand eight through March thirty-first, two thousand
55 eight.
S. 2108--C 40 A. 4308--C
1 (dd) Funds shall be deposited by the commissioner, within amounts
2 appropriated, and the state comptroller is hereby authorized and
3 directed to receive for deposit to the credit of the state special
4 revenue fund - other, HCRA transfer fund, medical assistance account, or
5 any successor fund or account, for purposes of funding the state share
6 of Medicaid expenditures for physician services from the tobacco control
7 and insurance initiatives pool established for the following periods in
8 the following amounts:
9 (i) up to fifty-two million dollars for the period January first, two
10 thousand two through December thirty-first, two thousand two;
11 (ii) eighty-one million two hundred thousand dollars for the period
12 January first, two thousand three through December thirty-first, two
13 thousand three;
14 (iii) eighty-five million two hundred thousand dollars for the period
15 January first, two thousand four through December thirty-first, two
16 thousand four;
17 (iv) eighty-five million two hundred thousand dollars for the period
18 January first, two thousand five through December thirty-first, two
19 thousand five;
20 (v) eighty-five million two hundred thousand dollars for the period
21 January first, two thousand six through December thirty-first, two thou-
22 sand six; [and]
23 (vi) [forty-two] eight-five million [six] two hundred thousand dollars
24 for the period January first, two thousand seven through [June thirti-
25 eth] December thirty-first, two thousand seven[.]; and
26 (vii) twenty-one million three hundred thousand dollars for the period
27 January first, two thousand eight through March thirty-first, two thou-
28 sand eight.
29 (ee) Funds shall be deposited by the commissioner, within amounts
30 appropriated, and the state comptroller is hereby authorized and
31 directed to receive for deposit to the credit of the state special
32 revenue fund - other, HCRA transfer fund, medical assistance account, or
33 any successor fund or account, for purposes of funding the state share
34 of the free-standing diagnostic and treatment center rate increases for
35 recruitment and retention of health care workers pursuant to subdivision
36 seventeen of section twenty-eight hundred seven of this chapter from the
37 tobacco control and insurance initiatives pool established for the
38 following periods in the following amounts:
39 (i) three million two hundred fifty thousand dollars for the period
40 April first, two thousand two through December thirty-first, two thou-
41 sand two;
42 (ii) three million two hundred fifty thousand dollars on an annualized
43 basis for the period January first, two thousand three through December
44 thirty-first, two thousand three;
45 (iii) three million two hundred fifty thousand dollars on an annual-
46 ized basis for the period January first, two thousand four through
47 December thirty-first, two thousand four;
48 (iv) three million two hundred fifty thousand dollars for the period
49 January first, two thousand five through December thirty-first, two
50 thousand five;
51 (v) three million two hundred fifty thousand dollars for the period
52 January first, two thousand six through December thirty-first, two thou-
53 sand six; [and]
54 (vi) [one] three million [six] two hundred [twenty-five] fifty thou-
55 sand dollars for the period January first, two thousand seven through
56 [June thirtieth] December thirty-first, two thousand seven[.]; and
S. 2108--C 41 A. 4308--C
1 (vii) eight hundred thirteen thousand dollars for the period January
2 first, two thousand eight through March thirty-first, two thousand
3 eight.
4 (ff) Funds shall be deposited by the commissioner, within amounts
5 appropriated, and the state comptroller is hereby authorized and
6 directed to receive for deposit to the credit of the state special
7 revenue fund - other, HCRA transfer fund, medical assistance account, or
8 any successor fund or account, for purposes of funding the state share
9 of Medicaid expenditures for disabled persons as authorized pursuant to
10 subparagraphs twelve and thirteen of paragraph (a) of subdivision one of
11 section three hundred sixty-six of the social services law from the
12 tobacco control and insurance initiatives pool established for the
13 following periods in the following amounts:
14 (i) one million eight hundred thousand dollars for the period April
15 first, two thousand two through December thirty-first, two thousand two;
16 (ii) sixteen million four hundred thousand dollars on an annualized
17 basis for the period January first, two thousand three through December
18 thirty-first, two thousand three;
19 (iii) eighteen million seven hundred thousand dollars on an annualized
20 basis for the period January first, two thousand four through December
21 thirty-first, two thousand four;
22 (iv) thirty million six hundred thousand dollars for the period Janu-
23 ary first, two thousand five through December thirty-first, two thousand
24 five;
25 (v) thirty million six hundred thousand dollars for the period January
26 first, two thousand six through December thirty-first, two thousand six;
27 [and]
28 (vi) [fifteen] thirty million [three] six hundred thousand dollars for
29 the period January first, two thousand seven through [June thirtieth]
30 December thirty-first, two thousand seven[.]; and
31 (vii) seven million six hundred fifty thousand dollars for the period
32 January first, two thousand eight through March thirty-first, two thou-
33 sand eight.
34 (gg) Funds shall be reserved and accumulated from year to year and
35 shall be available, including income from invested funds, for purposes
36 of grants to non-public general hospitals pursuant to paragraph (c) of
37 subdivision thirty of section twenty-eight hundred seven-c of this arti-
38 cle from the tobacco control and insurance initiatives pool established
39 for the following periods in the following amounts:
40 (i) up to one million three hundred thousand dollars on an annualized
41 basis for the period January first, two thousand two through December
42 thirty-first, two thousand two;
43 (ii) up to three million two hundred thousand dollars on an annualized
44 basis for the period January first, two thousand three through December
45 thirty-first, two thousand three;
46 (iii) up to five million six hundred thousand dollars on an annualized
47 basis for the period January first, two thousand four through December
48 thirty-first, two thousand four;
49 (iv) up to eight million six hundred thousand dollars for the period
50 January first, two thousand five through December thirty-first, two
51 thousand five;
52 (v) up to eight million six hundred thousand dollars on an annualized
53 basis for the period January first, two thousand six through December
54 thirty-first, two thousand six; [and]
S. 2108--C 42 A. 4308--C
1 (vi) up to two million [eight] six hundred thousand dollars for the
2 period January first, two thousand seven through [June thirtieth] Decem-
3 ber thirty-first, two thousand seven[.]; and
4 (vii) up to six hundred fifty thousand dollars for the period January
5 first, two thousand eight through March thirty-first, two thousand
6 eight.
7 (hh) Funds shall be deposited by the commissioner, within amounts
8 appropriated, and the state comptroller is hereby authorized and
9 directed to receive for deposit to the credit of the special revenue
10 fund - other, HCRA transfer fund, medical assistance account for
11 purposes of providing financial assistance to residential health care
12 facilities pursuant to subdivisions nineteen and twenty-one of section
13 twenty-eight hundred eight of this article, from the tobacco control and
14 insurance initiatives pool established for the following periods in the
15 following amounts:
16 (i) for the period April first, two thousand two through December
17 thirty-first, two thousand two, ten million dollars;
18 (ii) for the period January first, two thousand three through December
19 thirty-first, two thousand three, nine million four hundred fifty thou-
20 sand dollars;
21 (iii) for the period January first, two thousand four through December
22 thirty-first, two thousand four, nine million three hundred fifty thou-
23 sand dollars;
24 (iv) up to fifteen million dollars for the period January first, two
25 thousand five through December thirty-first, two thousand five;
26 (v) up to fifteen million dollars for the period January first, two
27 thousand six through December thirty-first, two thousand six; [and]
28 (vi) up to [seven] fifteen million [five hundred thousand] dollars for
29 the period January first, two thousand seven through [June thirtieth]
30 December thirty-first, two thousand seven[.]; and
31 (vii) up to three million seven hundred fifty thousand dollars for the
32 period January first, two thousand eight through March thirty-first, two
33 thousand eight.
34 (ii) Funds shall be deposited by the commissioner, within amounts
35 appropriated, and the state comptroller is hereby authorized and
36 directed to receive for deposit to the credit of the state special
37 revenue funds - other, HCRA transfer fund, medical assistance account,
38 or any successor fund or account, for the purpose of supporting the
39 state share of Medicaid expenditures for disabled persons as authorized
40 by sections 1619 (a) and (b) of the federal social security act pursuant
41 to the tobacco control and insurance initiatives pool established for
42 the following periods in the following amounts:
43 (i) six million four hundred thousand dollars for the period April
44 first, two thousand two through December thirty-first, two thousand two;
45 (ii) eight million five hundred thousand dollars, for the period Janu-
46 ary first, two thousand three through December thirty-first, two thou-
47 sand three;
48 (iii) eight million five hundred thousand dollars for the period Janu-
49 ary first, two thousand four through December thirty-first, two thousand
50 four;
51 (iv) eight million five hundred thousand dollars for the period Janu-
52 ary first, two thousand five through December thirty-first, two thousand
53 five;
54 (v) eight million five hundred thousand dollars for the period January
55 first, two thousand six through December thirty-first, two thousand six;
56 [and]
S. 2108--C 43 A. 4308--C
1 (vi) [four] eight million [three] six hundred thousand dollars for the
2 period January first, two thousand seven through [June thirtieth] Decem-
3 ber thirty-first, two thousand seven[.]; and
4 (vii) two million one hundred fifty thousand dollars for the period
5 January first, two thousand eight through March thirty-first, two thou-
6 sand eight.
7 (jj) Funds shall be reserved and accumulated from year to year and
8 shall be available, including income from invested funds, for the
9 purposes of a grant program to improve access to infertility services,
10 treatments and procedures, from the tobacco control and insurance initi-
11 atives pool established for the period January first, two thousand two
12 through December thirty-first, two thousand two in the amount of nine
13 million one hundred seventy-five thousand dollars [and], for the period
14 April first, two thousand six through March thirty-first, two thousand
15 seven in the amount of five million dollars, and for the period April
16 first, two thousand seven through March thirty-first, two thousand eight
17 in the amount of five million dollars.
18 (kk) Funds shall be deposited by the commissioner, within amounts
19 appropriated, and the state comptroller is hereby authorized and
20 directed to receive for deposit to the credit of the state special
21 revenue funds -- other, HCRA transfer fund, medical assistance account,
22 or any successor fund or account, for purposes of funding the state
23 share of Medicaid expenditures for pharmacy services from the tobacco
24 control and insurance initiatives pool established for the following
25 periods in the following amounts:
26 (i) thirty-eight million eight hundred thousand dollars for the period
27 January first, two thousand two through December thirty-first, two thou-
28 sand two;
29 (ii) up to two hundred ninety-five million dollars for the period
30 January first, two thousand three through December thirty-first, two
31 thousand three;
32 (iii) up to four hundred seventy-two million dollars for the period
33 January first, two thousand four through December thirty-first, two
34 thousand four;
35 (iv) up to nine hundred million dollars for the period January first,
36 two thousand five through December thirty-first, two thousand five;
37 (v) up to eight hundred sixty-six million three hundred thousand
38 dollars for the period January first, two thousand six through December
39 thirty-first, two thousand six; [and]
40 (vi) up to [two hundred twenty-eight] six hundred sixteen million
41 [eight] seven hundred thousand dollars for the period January first, two
42 thousand seven through [June thirtieth] December thirty-first, two thou-
43 sand seven[.]; and
44 (vii) up to one hundred fifty-four million one hundred seventy-five
45 thousand dollars for the period January first, two thousand eight
46 through March thirty-first, two thousand eight.
47 (ll) Funds shall be deposited by the commissioner, within amounts
48 appropriated, and the state comptroller is hereby authorized and
49 directed to receive for deposit to the credit of the state special
50 revenue funds -- other, HCRA transfer fund, medical assistance account,
51 or any successor fund or account, for purposes of funding the state
52 share of Medicaid expenditures related to the city of New York from the
53 tobacco control and insurance initiatives pool established for the
54 following periods in the following amounts:
S. 2108--C 44 A. 4308--C
1 (i) eighty-two million seven hundred thousand dollars for the period
2 January first, two thousand two through December thirty-first, two thou-
3 sand two;
4 (ii) one hundred twenty-four million six hundred thousand dollars for
5 the period January first, two thousand three through December thirty-
6 first, two thousand three;
7 (iii) one hundred twenty-four million seven hundred thousand dollars
8 for the period January first, two thousand four through December thir-
9 ty-first, two thousand four;
10 (iv) one hundred twenty-four million seven hundred thousand dollars
11 for the period January first, two thousand five through December thir-
12 ty-first, two thousand five;
13 (v) one hundred twenty-four million seven hundred thousand dollars for
14 the period January first, two thousand six through December thirty-
15 first, two thousand six; [and]
16 (vi) [sixty-two] one hundred twenty-four million [four] seven hundred
17 thousand dollars for the period January first, two thousand seven
18 through [June thirtieth] December thirty-first, two thousand seven[.];
19 and
20 (vii) thirty-one million one hundred seventy-five thousand dollars for
21 the period January first, two thousand eight through March thirty-first,
22 two thousand eight.
23 (mm) Funds shall be deposited by the commissioner, within amounts
24 appropriated, and the state comptroller is hereby authorized and
25 directed to receive for deposit to the credit of the state special
26 revenue funds - other, HCRA transfer fund, medical assistance account,
27 or any successor fund or account, for purposes of funding specified
28 percentages of the state share of services and expenses related to the
29 family health plus program in accordance with the following schedule:
30 (i) (A) for the period January first, two thousand three through
31 December thirty-first, two thousand four, one hundred percent of the
32 state share;
33 [(ii)] (B) for the period January first, two thousand five through
34 December thirty-first, two thousand five, seventy-five percent of the
35 state share; and,
36 [(iii)] (C) for periods beginning on and after January first, two
37 thousand six, fifty percent of the state share.
38 (ii) Funding for the family health plus program will include up to
39 five million dollars annually for the period January first, two thousand
40 three through December thirty-first, two thousand six, [and] up to [two]
41 five million [five hundred thousand] dollars for the period January
42 first, two thousand seven through [June thirtieth] December
43 thirty-first, two thousand seven, and up to one million two hundred
44 fifty thousand dollars for the period January first, two thousand eight
45 through March thirty-first, two thousand eight for administration and
46 marketing costs associated with such program established pursuant to
47 clauses (A) and (B) of subparagraph (v) of paragraph (a) of subdivision
48 two of section three hundred sixty-nine-ee of the social services law
49 from the tobacco control and insurance initiatives pool established for
50 the following periods in the following amount:
51 [(i)] (A) one hundred ninety million six hundred thousand dollars for
52 the period January first, two thousand three through December thirty-
53 first, two thousand three;
54 [(ii)] (B) three hundred seventy-four million dollars for the period
55 January first, two thousand four through December thirty-first, two
56 thousand four;
S. 2108--C 45 A. 4308--C
1 [(iii)] (C) five hundred thirty-eight million four hundred thousand
2 dollars for the period January first, two thousand five through December
3 thirty-first, two thousand five;
4 [(iv)] (D) three hundred eighteen million seven hundred seventy-five
5 thousand dollars for the period January first, two thousand six through
6 December thirty-first, two thousand six; [and]
7 [(v) one hundred sixty-two] (E) four hundred eighty-two million [two]
8 eight hundred [twenty-five] thousand dollars for the period January
9 first, two thousand seven through [June thirtieth] December
10 thirty-first, two thousand seven[.]; and
11 (F) one hundred twenty million seven hundred thousand dollars for the
12 period January first, two thousand eight through March thirty-first, two
13 thousand eight.
14 (nn) Funds shall be deposited by the commissioner, within amounts
15 appropriated, and the state comptroller is hereby authorized and
16 directed to receive for deposit to the credit of the state special
17 revenue fund - other, HCRA transfer fund, health care services account,
18 or any successor fund or account, for purposes related to adult home
19 initiatives for medicaid eligible residents of residential facilities
20 licensed pursuant to section four hundred sixty-b of the social services
21 law from the tobacco control and insurance initiatives pool established
22 for the following periods in the following amounts:
23 (i) up to four million dollars for the period January first, two thou-
24 sand three through December thirty-first, two thousand three;
25 (ii) up to six million dollars for the period January first, two thou-
26 sand four through December thirty-first, two thousand four;
27 (iii) up to eight million dollars for the period January first, two
28 thousand five through December thirty-first, two thousand five,
29 provided, however, that up to five million two hundred fifty thousand
30 dollars of such funds shall be received by the comptroller and deposited
31 to the credit of the special revenue fund - other / aid to localities,
32 HCRA transfer fund - 061, enhanced community services account - 05, or
33 any successor fund or account, for the purposes set forth in this para-
34 graph;
35 (iv) up to eight million dollars for the period January first, two
36 thousand six through December thirty-first, two thousand six, provided,
37 however, that up to five million two hundred fifty thousand dollars of
38 such funds shall be received by the comptroller and deposited to the
39 credit of the special revenue fund - other / aid to localities, HCRA
40 transfer fund - 061, enhanced community services account - 05, or any
41 successor fund or account, for the purposes set forth in this paragraph;
42 [and]
43 (v) up to [four] eight million dollars for the period January first,
44 two thousand seven through [June thirtieth] December thirty-first, two
45 thousand seven, provided, however, that up to [two] five million [six]
46 two hundred [twenty-five] fifty thousand dollars of such funds shall be
47 received by the comptroller and deposited to the credit of the special
48 revenue fund - other / aid to localities, HCRA transfer fund - 061,
49 enhanced community services account - 05, or any successor fund or
50 account, for the purposes set forth in this paragraph[.]; and
51 (vi) up to two million dollars for the period January first, two thou-
52 sand eight through March thirty-first, two thousand eight, provided,
53 however, that up to one million three hundred thirteen thousand dollars
54 of such funds shall be received by the comptroller and deposited to the
55 credit of the special revenue fund - other / aid to localities, HCRA
S. 2108--C 46 A. 4308--C
1 transfer fund - 061, enhanced community services account - 05, or any
2 successor fund or account, for the purposes set forth in this paragraph.
3 (oo) Funds shall be reserved and accumulated from year to year and
4 shall be available, including income from invested funds, for purposes
5 of grants to non-public general hospitals pursuant to paragraph (e) of
6 subdivision twenty-five of section twenty-eight hundred seven-c of this
7 article from the tobacco control and insurance initiatives pool estab-
8 lished for the following periods in the following amounts:
9 (i) up to five million dollars on an annualized basis for the period
10 January first, two thousand four through December thirty-first, two
11 thousand four;
12 (ii) up to five million dollars for the period January first, two
13 thousand five through December thirty-first, two thousand five;
14 (iii) up to five million dollars for the period January first, two
15 thousand six through December thirty-first, two thousand six; [and]
16 (iv) up to [two] five million [five hundred thousand] dollars for the
17 period January first, two thousand seven through [June thirtieth] Decem-
18 ber thirty-first, two thousand seven[.]; and
19 (v) up to one million two hundred fifty thousand dollars for the peri-
20 od January first, two thousand eight through March thirty-first, two
21 thousand eight.
22 (pp) Funds shall be reserved and accumulated from year to year and
23 shall be available, including income from invested funds, for the
24 purpose of supporting the provision of tax credits for long term care
25 insurance pursuant to subdivision one of section one hundred ninety of
26 the tax law, paragraph (a) of subdivision twenty-five-a of section two
27 hundred ten of such law, subsection (aa) of section six hundred six of
28 such law, paragraph one of subsection (k) of section fourteen hundred
29 fifty-six of such law and paragraph one of subdivision (m) of section
30 fifteen hundred eleven of such law, in the following amounts:
31 (i) ten million dollars for the period January first, two thousand
32 four through December thirty-first, two thousand four;
33 (ii) ten million dollars for the period January first, two thousand
34 five through December thirty-first, two thousand five;
35 (iii) ten million dollars for the period January first, two thousand
36 six through December thirty-first, two thousand six; and
37 (iv) five million dollars for the period January first, two thousand
38 seven through June thirtieth, two thousand seven.
39 (qq) Funds shall be reserved and accumulated from year to year and
40 shall be available, including income from invested funds, for the
41 purpose of supporting the long-term care insurance education and
42 outreach program established pursuant to section two hundred seventeen-a
43 of the elder law for the following periods in the following amounts:
44 (i) up to five million dollars for the period January first, two thou-
45 sand four through December thirty-first, two thousand four; of such
46 funds one million nine hundred fifty thousand dollars shall be made
47 available to the department for the purpose of developing, implementing
48 and administering the long-term care insurance education and outreach
49 program and three million fifty thousand dollars shall be deposited by
50 the commissioner, within amounts appropriated, and the comptroller is
51 hereby authorized and directed to receive for deposit to the credit of
52 the special revenue funds - other, HCRA transfer fund, long term care
53 insurance resource center account of the state office for the aging or
54 any future account designated for the purpose of implementing the long
55 term care insurance education and outreach program and providing the
S. 2108--C 47 A. 4308--C
1 long term care insurance resource centers with the necessary resources
2 to carry out their operations.
3 (ii) up to five million dollars for the period January first, two
4 thousand five through December thirty-first, two thousand five; of such
5 funds one million nine hundred fifty thousand dollars shall be made
6 available to the department for the purpose of developing, implementing
7 and administering the long-term care insurance education and outreach
8 program and three million fifty thousand dollars shall be deposited by
9 the commissioner, within amounts appropriated, and the comptroller is
10 hereby authorized and directed to receive for deposit to the credit of
11 the special revenue funds - other, HCRA transfer fund, long term care
12 insurance resource center account of the state office for the aging or
13 any future account designated for the purpose of implementing the long
14 term care insurance education and outreach program and providing the
15 long term care insurance resource centers with the necessary resources
16 to carry out their operations.
17 (iii) up to five million dollars for the period January first, two
18 thousand six through December thirty-first, two thousand six; of such
19 funds one million nine hundred fifty thousand dollars shall be made
20 available to the department for the purpose of developing, implementing
21 and administering the long-term care insurance education and outreach
22 program and three million fifty thousand dollars shall be made available
23 to the office for the aging for the purpose of providing the long term
24 care insurance resource centers with the necessary resources to carry
25 out their operations.
26 (iv) up to [two] five million [five hundred thousand] dollars for the
27 period January first, two thousand seven through [June thirtieth] Decem-
28 ber thirty-first, two thousand seven; of such funds one million nine
29 hundred [seventy-five] fifty thousand dollars shall be made available to
30 the department for the purpose of developing, implementing and adminis-
31 tering the long-term care insurance education and outreach program and
32 [one] three million [five hundred twenty-five] fifty thousand dollars
33 shall be made available to the office for the aging for the purpose of
34 providing the long term care insurance resource centers with the neces-
35 sary resources to carry out their operations[.]; and
36 (v) up to one million two hundred fifty thousand dollars for the peri-
37 od January first, two thousand eight through March thirty-first, two
38 thousand eight; of such funds four hundred eighty-eight thousand dollars
39 shall be made available to the department for the purpose of developing,
40 implementing and administering the long term care insurance education
41 and outreach program and seven hundred sixty-three thousand dollars
42 shall be made available to the office for the aging for the purpose of
43 providing the long term care insurance resource centers with the neces-
44 sary resources to carry out their operations.
45 (rr) Funds shall be reserved and accumulated from the tobacco control
46 and insurance initiatives pool and shall be available, including income
47 from invested funds, for the purpose of supporting expenses related to
48 implementation of the provisions of title III of article twenty-nine-D
49 of this chapter, for the following periods and in the following amounts:
50 (i) up to ten million dollars for the period January first, two thou-
51 sand six through December thirty-first, two thousand six; [and]
52 (ii) up to [five] ten million dollars for the period January first,
53 two thousand seven through [June thirtieth] December thirty-first, two
54 thousand seven[.]; and
S. 2108--C 48 A. 4308--C
1 (iii) up to two million five hundred thousand dollars for the period
2 January first, two thousand eight through March thirty-first, two thou-
3 sand eight.
4 (ss) Funds shall be reserved and accumulated from the tobacco control
5 and insurance initiatives pool and used for a health care stabilization
6 program established by the commissioner for the purposes of stabilizing
7 critical health care providers and health care programs whose ability to
8 continue to provide appropriate services are threatened by financial or
9 other challenges, in the amount of up to twenty-eight million dollars
10 for the period July first, two thousand four through June thirtieth, two
11 thousand five. Notwithstanding the provisions of section one hundred
12 twelve of the state finance law or any other inconsistent provision of
13 the state finance law or any other law, funds available for distribution
14 pursuant to this paragraph may be allocated and distributed by the
15 commissioner, or the state comptroller as applicable without a compet-
16 itive bid or request for proposal process. Considerations relied upon by
17 the commissioner in determining the allocation and distribution of these
18 funds shall include, but not be limited to, the following: (i) the
19 importance of the provider or program in meeting critical health care
20 needs in the community in which it operates; (ii) the provider or
21 program provision of care to under-served populations; (iii) the quality
22 of the care or services the provider or program delivers; (iv) the abil-
23 ity of the provider or program to continue to deliver an appropriate
24 level of care or services if additional funding is made available; (v)
25 the ability of the provider or program to access, in a timely manner,
26 alternative sources of funding, including other sources of government
27 funding; (vi) the ability of other providers or programs in the communi-
28 ty to meet the community health care needs; (vii) whether the provider
29 or program has an appropriate plan to improve its financial condition;
30 and (viii) whether additional funding would permit the provider or
31 program to consolidate, relocate, or close programs or services where
32 such actions would result in greater stability and efficiency in the
33 delivery of needed health care services or programs.
34 (tt) Funds shall be reserved and accumulated from year to year and
35 shall be available, including income from invested funds, for purposes
36 of providing grants for two long term care demonstration projects
37 designed to test new models for the delivery of long term care services
38 established pursuant to section twenty-eight hundred seven-x of this
39 chapter, for the following periods and in the following amounts:
40 (i) up to five hundred thousand dollars for the period January first,
41 two thousand four through December thirty-first, two thousand four;
42 (ii) up to five hundred thousand dollars for the period January first,
43 two thousand five through December thirty-first, two thousand five;
44 (iii) up to five hundred thousand dollars for the period January
45 first, two thousand six through December thirty-first, two thousand six;
46 [and]
47 (iv) up to [two hundred fifty thousand] one million dollars for the
48 period January first, two thousand seven through [June thirtieth] Decem-
49 ber thirty-first, two thousand seven[.]; and
50 (v) up to two hundred fifty thousand dollars for the period January
51 first, two thousand eight through March thirty-first, two thousand
52 eight.
53 (uu) Funds shall be reserved and accumulated from year to year and
54 shall be available, including income from invested funds, for the
55 purpose of supporting disease management and telemedicine demonstration
56 programs authorized pursuant to sections twenty-one hundred eleven and
S. 2108--C 49 A. 4308--C
1 thirty-six hundred twenty-one of this chapter, respectively, for the
2 following periods in the following amounts:
3 (i) five million dollars for the period January first, two thousand
4 four through December thirty-first, two thousand four, of which three
5 million dollars shall be available for disease management demonstration
6 programs and two million dollars shall be available for telemedicine
7 demonstration programs;
8 (ii) five million dollars for the period January first, two thousand
9 five through December thirty-first, two thousand five, of which three
10 million dollars shall be available for disease management demonstration
11 programs and two million dollars shall be available for telemedicine
12 demonstration programs;
13 (iii) nine million five hundred thousand dollars for the period Janu-
14 ary first, two thousand six through December thirty-first, two thousand
15 six, of which seven million five hundred thousand dollars shall be
16 available for disease management demonstration programs and two million
17 dollars shall be available for telemedicine demonstration programs;
18 [and]
19 (iv) [four] nine million [seven] five hundred [fifty] thousand dollars
20 for the period January first, two thousand seven through [June thirti-
21 eth] December thirty-first, two thousand seven, of which [three] seven
22 million [seven] five hundred [fifty] thousand dollars shall be available
23 for disease management demonstration programs and one million dollars
24 shall be available for telemedicine demonstration programs[.]; and
25 (v) two million three hundred seventy-five thousand dollars for the
26 period January first, two thousand eight through March thirty-first, two
27 thousand eight, of which one million eight hundred seventy-five thousand
28 dollars shall be available for disease management demonstration programs
29 and five hundred thousand dollars shall be available for telemedicine
30 demonstration programs.
31 (ww) Funds shall be deposited by the commissioner, within amounts
32 appropriated, and the state comptroller is hereby authorized and
33 directed to receive for the deposit to the credit of the state special
34 revenue funds - other, HCRA transfer fund, medical assistance account,
35 or any successor fund or account, for purposes of funding the state
36 share of the general hospital rates increases for recruitment and
37 retention of health care workers pursuant to paragraph (e) of subdivi-
38 sion thirty of section twenty-eight hundred seven-c of this article from
39 the tobacco control and insurance initiatives pool established for the
40 following periods in the following amounts:
41 (i) sixty million five hundred thousand dollars for the period January
42 first, two thousand five through December thirty-first, two thousand
43 five; and
44 (ii) sixty million five hundred thousand dollars for the period Janu-
45 ary first, two thousand six through December thirty-first, two thousand
46 six.
47 (xx) Funds shall be deposited by the commissioner, within amounts
48 appropriated, and the state comptroller is hereby authorized and
49 directed to receive for the deposit to the credit of the state special
50 revenue funds - other, HCRA transfer fund, medical assistance account,
51 or any successor fund or account, for purposes of funding the state
52 share of the general hospital rates increases for rural hospitals pursu-
53 ant to subdivision thirty-two of section twenty-eight hundred seven-c of
54 this article from the tobacco control and insurance initiatives pool
55 established for the following periods in the following amounts:
S. 2108--C 50 A. 4308--C
1 (i) three million five hundred thousand dollars for the period January
2 first, two thousand five through December thirty-first, two thousand
3 five;
4 (ii) three million five hundred thousand dollars for the period Janu-
5 ary first, two thousand six through December thirty-first, two thousand
6 six; and
7 (iii) provided, however, in the event federal financial participation
8 is not available with regard to rate adjustments pursuant to subdivision
9 thirty-two of section twenty-eight hundred seven-c of this article,
10 allocations pursuant to this paragraph shall, on an annualized basis be
11 increased to seven million dollars for the period January first, two
12 thousand five through December thirty-first, two thousand six.
13 (yy) Funds shall be reserved and accumulated from year to year and
14 shall be available, within amounts appropriated and notwithstanding
15 section one hundred twelve of the state finance law and any other
16 contrary provision of law, for the purpose of supporting grants not to
17 exceed five million dollars to be made by the commissioner without a
18 competitive bid or request for proposal process, in support of the
19 delivery of critically needed health care services, to health care
20 providers located in the counties of Erie and Niagara which executed a
21 memorandum of closing and conducted a merger closing in escrow on Novem-
22 ber twenty-fourth, nineteen hundred ninety-seven and which entered into
23 a settlement dated December thirtieth, two thousand four for a loss on
24 disposal of assets under the provisions of title XVIII of the federal
25 social security act applicable to mergers occurring prior to December
26 first, nineteen hundred ninety-seven.
27 (zz) Funds shall be reserved and accumulated from year to year and
28 shall be available, within amounts appropriated, for the purpose of
29 supporting expenditures authorized pursuant to section twenty-eight
30 hundred eighteen of this article from the tobacco control and insurance
31 initiatives pool established for the following periods in the following
32 amounts:
33 (i) six million five hundred thousand dollars for the period January
34 first, two thousand five through December thirty-first, two thousand
35 five;
36 (ii) one hundred eight million three hundred thousand dollars for the
37 period January first, two thousand six through December thirty-first,
38 two thousand six, provided, however, that within amounts appropriated in
39 the two thousand six through two thousand seven state fiscal year, a
40 portion of such funds may be transferred to the Roswell Park Cancer
41 Institute Corporation to fund capital costs; [and]
42 (iii) [eighty] one hundred seventy-one million [eight hundred thou-
43 sand] dollars for the period January first, two thousand seven through
44 [June thirtieth] December thirty-first, two thousand seven, provided,
45 however, that within amounts appropriated in the two thousand six
46 through two thousand seven state fiscal year, a portion of such funds
47 may be transferred to the Roswell Park Cancer Institute Corporation to
48 fund capital costs[.]; and
49 (iv) forty million four hundred thousand dollars for the period Janu-
50 ary first, two thousand eight through March thirty-first, two thousand
51 eight.
52 (aaa) Funds shall be reserved and accumulated from year to year and
53 shall be available, including income from invested funds, for services
54 and expenses related to school based health centers, in an amount up to
55 three million five hundred thousand dollars for the period April first,
56 two thousand six through March thirty-first, two thousand seven, and up
S. 2108--C 51 A. 4308--C
1 to three million five hundred thousand dollars for the period April
2 first, two thousand seven through March thirty-first, two thousand
3 eight. The total amount of funds provided herein shall be distributed
4 as grants based on the ratio of each provider's total enrollment for all
5 sites to the total enrollment of all providers. This formula shall be
6 applied to the total amount provided herein.
7 (bbb) Funds shall be reserved and accumulated from year to year and
8 shall be available, including income from invested funds, for purposes
9 of awarding grants to operators of adult homes, enriched housing
10 programs and residences through the enhancing abilities and life experi-
11 ence (EnAbLe) program to provide for the installation, operation and
12 maintenance of air conditioning in resident rooms, consistent with this
13 paragraph, in an amount up to two million dollars for the period April
14 first, two thousand six through March thirty-first, two thousand seven,
15 and up to three million eight hundred thousand dollars for the period
16 April first, two thousand seven through March thirty-first, two thousand
17 eight. Residents shall not be charged utility cost for the use of air
18 conditioners supplied under the EnAbLe program. All such air condition-
19 ers must be operated in occupied resident rooms consistent with require-
20 ments applicable to common areas.
21 (ccc) Funds shall be deposited by the commissioner, within amounts
22 appropriated, and the state comptroller is hereby authorized and
23 directed to receive for the deposit to the credit of the state special
24 revenue funds - other, HCRA transfer fund, medical assistance account,
25 or any successor fund or account, for purposes of funding the state
26 share of increases in the rates for certified home health agencies, long
27 term home health care programs, AIDS home care programs, hospice
28 programs and managed long term care plans and approved managed long term
29 care operating demonstrations as defined in section forty-four hundred
30 three-f of this chapter for recruitment and retention of health care
31 workers pursuant to subdivisions nine and ten of section thirty-six
32 hundred fourteen of this chapter from the tobacco control and insurance
33 initiatives pool established for the following periods in the following
34 amounts:
35 (i) twenty-five million dollars for the period June first, two thou-
36 sand six through December thirty-first, two thousand six; [and]
37 (ii) [twenty-five] fifty million dollars for the period January first,
38 two thousand seven through [June thirtieth] December thirty-first, two
39 thousand seven[.]; and
40 (iii) twelve million five hundred thousand dollars for the period
41 January first, two thousand eight through March thirty-first, two thou-
42 sand eight.
43 (ddd) Funds shall be deposited by the commissioner, within amounts
44 appropriated, and the state comptroller is hereby authorized and
45 directed to receive for the deposit to the credit of the state special
46 revenue funds - other, HCRA transfer fund, medical assistance account,
47 or any successor fund or account, for purposes of funding the state
48 share of increases in the medical assistance rates for providers for
49 purposes of enhancing the provision, quality and/or efficiency of home
50 care services pursuant to subdivision eleven of section thirty-six
51 hundred fourteen of this chapter from the tobacco control and insurance
52 initiatives pool established for the following [periods] period in the
53 [following amounts:
54 (i)] amount of eight million dollars for the period April first, two
55 thousand six through December thirty-first, two thousand six[; and
S. 2108--C 52 A. 4308--C
1 (ii) four million dollars for the period January first, two thousand
2 seven through June thirtieth, two thousand seven].
3 (eee) Funds shall be reserved and accumulated from year to year and
4 shall be available, including income from invested funds, to the Center
5 for Functional Genomics at the State University of New York at Albany,
6 for the purposes of the Adirondack network for cancer education and
7 research in rural communities grant program to improve access to health
8 care and shall be made available from the tobacco control and insurance
9 initiatives pool established for the following [periods] period in the
10 [following amounts:
11 (i)] amount of up to five million dollars for the period January
12 first, two thousand six through December thirty-first, two thousand
13 six[;
14 (ii) up to two million five hundred thousand dollars for the period
15 January first, two thousand seven through June thirtieth, two thousand
16 seven].
17 (fff) Funds shall be made available to the empire state stem cell fund
18 established by section ninety-nine-p of the state finance law from the
19 public asset as defined in section four thousand three hundred one of
20 the insurance law and accumulated from the conversion of one or more
21 article forty-three corporations and its or their not-for-profit subsid-
22 iaries occurring on or after January first, two thousand seven. Such
23 funds shall be made available within amounts appropriated up to fifty
24 million dollars annually and shall not exceed five hundred million
25 dollars in total.
26 2. (a) For periods prior to January first, two thousand five, the
27 commissioner is authorized to contract with the article forty-three
28 insurance law plans, or such other contractors as the commissioner shall
29 designate, to receive and distribute funds from the tobacco control and
30 insurance initiatives pool established pursuant to this section. In the
31 event contracts with the article forty-three insurance law plans or
32 other commissioner's designees are effectuated, the commissioner shall
33 conduct annual audits of the receipt and distribution of such funds. The
34 reasonable costs and expenses of an administrator as approved by the
35 commissioner, not to exceed for personnel services on an annual basis
36 five hundred thousand dollars, for collection and distribution of funds
37 pursuant to this section shall be paid from such funds.
38 (b) Notwithstanding any inconsistent provision of section one hundred
39 twelve or one hundred sixty-three of the state finance law or any other
40 law, at the discretion of the commissioner without a competitive bid or
41 request for proposal process, contracts in effect for administration of
42 pools established pursuant to sections twenty-eight hundred seven-k,
43 twenty-eight hundred seven-l and twenty-eight hundred seven-m of this
44 article for the period January first, nineteen hundred ninety-nine
45 through December thirty-first, nineteen hundred ninety-nine may be
46 extended to provide for administration pursuant to this section and may
47 be amended as may be necessary.
48 [3. Revenue from distributions pursuant to this section shall not be
49 included in gross revenue received for purposes of the assessments
50 pursuant to subdivision eighteen of section twenty-eight hundred seven-c
51 of this article, subject to the provisions of paragraph (e) of subdivi-
52 sion eighteen of section twenty-eight hundred seven-c of this article,
53 and shall not be included in gross revenue received for purposes of the
54 assessments pursuant to section twenty-eight hundred seven-d of this
55 article, subject to the provisions of subdivision twelve of section
56 twenty-eight hundred seven-d of this article.
S. 2108--C 53 A. 4308--C
1 4. In the event residual funds are available in the tobacco control
2 and insurance initiatives pool established for the periods January
3 first, two thousand through June thirtieth, two thousand seven, after
4 allocations have been made pursuant to this section for the periods
5 January first, two thousand through June thirtieth, two thousand seven,
6 any amount of such funds may be transferred to the health care initi-
7 atives pool established pursuant to section twenty-eight hundred seven-l
8 of this article for the periods January first, two thousand through June
9 thirtieth, two thousand seven, to be allocated and distributed propor-
10 tionally among affected programs by the commissioner to cover any short-
11 fall in programs and purposes set forth in subdivision one of section
12 twenty-eight hundred seven-l of this article.]
13 § 7. Subdivision 3 of section 1680-j of the public authorities law, as
14 amended by section 30 of part D of chapter 57 of the laws of 2006, is
15 amended to read as follows:
16 3. Notwithstanding any law [in] to the contrary, and in accordance
17 with section four of the state finance law, the comptroller is hereby
18 authorized and directed to transfer from the health care reform act
19 (HCRA) resources fund (061) to the general fund, upon the request of the
20 director of the budget, up to $6,500,000 on or before March 31, 2006,
21 and the comptroller is further hereby authorized and directed to trans-
22 fer from the healthcare reform act (HCRA); Resources fund (061) to the
23 Capital Projects Fund, upon the request of the director of budget, up to
24 $139,000,000 for the period April 1, 2006 through March 31, 2007, up to
25 [$170,976,000] $171,100,000 for the period April 1, 2007 through March
26 31, 2008, [and] up to [$198,408,000] $208,100,000 for the period April
27 1, 2008 through March 31, 2009, and up to $151,600,000 for the period
28 April 1, 2009 through March 31, 2010.
29 § 7-a. Section 2818 of the public health law is amended by adding a
30 new subdivision 3 to read as follows:
31 3. Notwithstanding subdivisions one and two of this section, sections
32 one hundred twelve and one hundred sixty-three of the state finance law,
33 or any other inconsistent provision of law, of the funds available for
34 expenditure pursuant to this section, thirty million dollars may be
35 allocated and distributed by the commissioner without a competitive bid
36 or request for proposal process for grants to residential health care
37 facilities for the purpose of restructuring such facilities to achieve a
38 reduction in certified inpatient bed capacity. Consideration relied
39 upon by the commissioner in determining the allocation and distribution
40 of these funds shall include, but not be limited to, the following: (a)
41 the existing and projected need for inpatient nursing home beds and
42 community based long-term care services in the area in which a facility
43 applying for such funds is located; (b) the quality of the care being
44 provided by the facility; (c) the ability of the facility to access, in
45 a timely manner, alternative sources of funding, including other sources
46 of government funding; and (d) whether additional funding would permit
47 the facility to achieve greater stability and efficiency in the delivery
48 of needed health care services.
49 § 8. Subparagraph (x) of paragraph (a) of subdivision 6 of section
50 2807-s of the public health law, as added by section 32 of part B of
51 chapter 58 of the laws of 2005, is amended and a new subparagraph (xi)
52 is added to read as follows:
53 (x) A gross statewide amount for the period January first, two thou-
54 sand seven through [June thirtieth] March thirty-first, two thousand
55 seven shall be [three hundred thirty-seven] one hundred sixty-eight
56 million five hundred thousand dollars, and for the period April first,
S. 2108--C 54 A. 4308--C
1 two thousand seven through December thirty-first, two thousand seven
2 shall be five hundred sixty-one million seven hundred fifty thousand
3 dollars.
4 (xi) A gross statewide amount for the period January first, two thou-
5 sand eight through March thirty-first, two thousand eight, shall be one
6 hundred eighty-seven million two hundred fifty thousand dollars.
7 § 9. Paragraph (b) of subdivision 6 of section 2807-s of the public
8 health law, as amended by chapter 1 of the laws of 1999, is amended to
9 read as follows:
10 (b) [For each year, the] The amount specified in paragraph (a) of this
11 subdivision shall be allocated among the regions based on each region's
12 proportional share of the sum of the estimated revenue of all general
13 hospitals in the region, excluding revenue related to services provided
14 to beneficiaries of title XVIII of the federal social security act
15 (medicare), related to one hundred percent of the direct medical educa-
16 tion expenses and fifty-nine and five-tenths percent of indirect medical
17 education expenses reflected in general hospital inpatient revenue
18 compared to the sum of such amounts for all regions, based on estimated
19 nineteen hundred ninety-six data and statistics, excluding an estimate
20 of revenue from services provided to patients eligible for payments by
21 governmental agencies, patients eligible for payments pursuant to the
22 comprehensive motor vehicle insurance reparations act, the workers'
23 compensation law, the volunteer firefighters' benefit law, and the
24 volunteer ambulance workers' benefit law, and self-pay patients.
25 § 10. Subparagraphs (iv) and (v) of paragraph (c) of subdivision 6 of
26 section 2807-s of the public health law, as amended by section 33 of
27 part B of chapter 58 of the laws of 2005, are amended to read as
28 follows:
29 (iv) A further gross annual statewide amount for two thousand, two
30 thousand one, two thousand two, two thousand three, two thousand four,
31 two thousand five [and], two thousand six and two thousand seven, shall
32 be eighty-nine million dollars.
33 (v) A further gross statewide amount for the period January first, two
34 thousand [seven] eight through [June thirtieth] March thirty-first, two
35 thousand [seven] eight, shall be [forty-four] twenty-two million [five
36 hundred] two hundred fifty thousand dollars.
37 § 11. Subparagraphs (i) and (ii) of paragraph (e) of subdivision 6 of
38 section 2807-s of the public health law, as amended by section 34 of
39 part B of chapter 58 of the laws of 2005, are amended to read as
40 follows:
41 (i) A further gross annual statewide amount shall be twelve million
42 dollars for each period prior to January first, two thousand [seven]
43 eight.
44 (ii) A further gross statewide amount for the period January first,
45 two thousand [seven] eight through [June thirtieth] March thirty-first,
46 two thousand [seven] eight shall be [six] three million dollars.
47 § 12. Paragraph (d) of subdivision 18 of section 2807-c of the public
48 health law, as amended by section 12 of part D of chapter 57 of the laws
49 of 2006, is amended to read as follows:
50 (d) Gross revenue received shall mean all moneys received for or on
51 account of inpatient hospital service, provided, however, that subject
52 to the provisions of paragraph (e) of this subdivision gross revenue
53 received shall not include distributions from bad debt and charity care
54 regional pools, health care services pools, bad debt and charity care
55 for financially distressed hospitals statewide pools and bad debt and
56 charity care and capital statewide pools created in accordance with this
S. 2108--C 55 A. 4308--C
1 section or distributions from funds allocated in accordance with section
2 twenty-eight hundred seven-l, twenty-eight hundred seven-k, twenty-eight
3 hundred seven-v or twenty-eight hundred seven-w of this article and
4 shall not include the components of rates of payment or charges related
5 to the allowances provided in accordance with subdivisions fourteen,
6 fourteen-b and fourteen-c of this section, the adjustment provided in
7 accordance with subdivision fourteen-a of this section, the adjustment
8 provided in accordance with subdivision fourteen-d of this section, the
9 adjustment for health maintenance organization reimbursement rates
10 provided in accordance with former subdivision two-a of this section,
11 or, if effective, the adjustment provided in accordance with subdivision
12 fifteen of this section, the adjustment provided in accordance with
13 section eighteen of chapter two hundred sixty-six of the laws of nine-
14 teen hundred eighty-six as amended, revenue received from physician
15 practice or faculty practice plan discrete billings for private practic-
16 ing physician services, revenue from affiliation agreements or contracts
17 with public hospitals for the delivery of health care services at such
18 public hospitals, revenue received as disproportionate share hospital
19 payments in accordance with title nineteen of the federal social securi-
20 ty act, or revenue from government deficit financing, provided, however,
21 that funds received as medical assistance payments which include state
22 share amounts authorized pursuant to section twenty-eight hundred
23 seven-v of this article that are not disproportionate share hospital
24 payments shall be included within the meaning of gross revenue for
25 purposes of this subdivision.
26 § 13. Subparagraph (iv) of paragraph (a) of subdivision 3 of section
27 2807-j of the public health law, as amended by chapter 1 of the laws of
28 1999, is amended to read as follows:
29 (iv) revenue received from bad debt and charity care and indigent care
30 rate adjustments and pool distributions pursuant to section twenty-eight
31 hundred seven-c of this article, general hospital indigent care pool
32 distributions pursuant to section twenty-eight hundred seven-k of this
33 article, health care services pool distributions pursuant to section
34 twenty-eight hundred seven-c of this article, health care initiatives
35 pool distributions pursuant to section twenty-eight hundred seven-l of
36 this article, professional education pool distributions pursuant to
37 section twenty-eight hundred seven-m of this article, tobacco control
38 and insurance initiatives pool distributions pursuant to section twen-
39 ty-eight hundred seven-v of this article, and high need indigent care
40 adjustment pool distributions pursuant to section twenty-eight hundred
41 seven-w of this article, provided, however, that funds received as
42 medical assistance payments which include state share amounts authorized
43 pursuant to section twenty-eight hundred seven-v of this article that
44 are not disproportionate share hospital payments shall be included with-
45 in the meaning of net patient service revenue for the purposes of this
46 section;
47 § 14. Paragraph (b) of subdivision 1 of section 76 of chapter 731 of
48 the laws of 1993 amending the public health law and other laws relating
49 to reimbursement, delivery and capital costs of ambulatory health care
50 services and inpatient hospital services, as amended by section 26 of
51 part B of chapter 58 of the laws of 2005, is amended to read as follows:
52 (b) sections fifteen through nineteen[,] and subdivision 3 of section
53 2807-e of the public health law as added by section twenty of this act
54 shall expire on July 1, 2011, and section seventy-four of this act shall
55 expire on July 1, 2007;
S. 2108--C 56 A. 4308--C
1 § 15. Paragraph (a) of subdivision 12 of section 367-b of the social
2 services law, as amended by section 27 of part B of chapter 58 of the
3 laws of 2005, is amended to read as follows:
4 (a) For the purpose of regulating cash flow for general hospitals, the
5 department shall develop and implement a payment methodology to provide
6 for timely payments for inpatient hospital services eligible for case
7 based payments per discharge based on diagnosis-related groups provided
8 during the period January first, nineteen hundred eighty-eight through
9 [June thirtieth] March thirty-first two thousand [seven] eight, by such
10 hospitals which elect to participate in the system.
11 § 16. Section 2 of chapter 600 of the laws of 1986 amending the public
12 health law relating to the development of pilot reimbursement programs
13 for ambulatory care services, as amended by section 29 of part B of
14 chapter 58 of the laws of 2005, is amended to read as follows:
15 § 2. This act shall take effect immediately, except that this act
16 shall expire and be of no further force and effect on and after [July 1,
17 2007] April 1, 2008; provided, however, that the commissioner of health
18 shall submit a report to the governor and the legislature detailing the
19 objective, impact, design and computation of any pilot reimbursement
20 program established pursuant to this act, on or before March 31, 1994
21 and annually thereafter. Such report shall include an assessment of the
22 financial impact of such payment system on providers, as well as the
23 impact of such system on access to care.
24 § 17. Section 11 of chapter 753 of the laws of 1989 amending the
25 public health law and other laws relating to general hospital reimburse-
26 ment for inpatient and ambulatory surgery, as amended by section 30 of
27 part B of chapter 58 of the laws of 2005, is amended to read as follows:
28 § 11. This act shall take effect immediately; provided, however, that
29 section one shall expire and have no further force or effect on or after
30 [July 1, 2007] April 1, 2008, section two of this act shall be deemed to
31 have been in full force and effect on and after January 1, 1988,
32 sections three through eight of this act shall be deemed to have been in
33 full force and effect on and after January 1, 1989, and that the amend-
34 ments made to section 2807-c of the public health law by sections two
35 through six of this act shall expire on the same date as such section
36 expires.
37 § 17-a. Paragraph (i) of subdivision (b) of section 1 of chapter 520
38 of the laws of 1978, relating to providing for a comprehensive survey of
39 health care financing, education and illness prevention and creating
40 councils for the conduct thereof, as amended by section 28 of part B of
41 chapter 58 of the laws of 2005, is amended to read as follows:
42 (i) oversight and evaluation of the inpatient financing system in
43 place for 1988 through June 30, [2007] 2009, and the appropriateness and
44 effectiveness of the bad debt and charity care financing provisions;
45 § 18. Subparagraphs (i) and (iii) of paragraph (d) of subdivision 3 of
46 section 2807-m of the public health law, as amended by section 46 of
47 part B of chapter 58 of the laws of 2005, are amended to read as
48 follows:
49 (i) the commissioner shall establish a reduction percentage by divid-
50 ing twenty-seven million dollars each year for the period January first,
51 two thousand through December thirty-first, two thousand [six] seven and
52 [thirteen] six million [five] seven hundred fifty thousand dollars for
53 the period January first, two thousand [seven] eight through [June thir-
54 tieth] March thirty-first, two thousand [seven] eight, by the sum of
55 initial hospital distribution amounts calculated pursuant to paragraph
56 (c) of this subdivision;
S. 2108--C 57 A. 4308--C
1 (iii) each teaching general hospital shall have its initial distrib-
2 ution amount as determined pursuant to paragraph (c) of this subdivision
3 reduced by an amount up to the amount calculated pursuant to subpara-
4 graph (ii) of this paragraph and subject to the requirements of subpara-
5 graph (iv) of this paragraph, provided, however, that if the sum of
6 reduction amounts for all facilities thus calculated is less than twen-
7 ty-seven million dollars on a statewide basis each year for the period
8 January first, two thousand through December thirty-first, two thousand
9 [six] seven and [thirteen] six million [five] seven hundred fifty thou-
10 sand dollars for the period January first, two thousand [seven] eight
11 through [June thirtieth] March thirty-first, two thousand [seven] eight,
12 the commissioner may increase the reduction percentage subject to the
13 provisions of subparagraph (iv) of this paragraph so that the sum of the
14 reduction amounts for all facilities is twenty-seven million dollars
15 each year for the period January first, two thousand through December
16 thirty-first, two thousand [six] seven and [thirteen] six million [five]
17 seven hundred fifty thousand dollars for the period January first, two
18 thousand [seven] eight through [June thirtieth] March thirty-first, two
19 thousand [seven] eight.
20 § 19. Paragraph (a) of subdivision 5 of section 2807-m of the public
21 health law, as amended by section 10 of part E of chapter 63 of the laws
22 of 2005, is amended to read as follows:
23 (a) Up to thirty-one million dollars annually for the periods January
24 first, two thousand through December thirty-first, two thousand three,
25 and up to twenty-five million dollars plus the sum of the amounts speci-
26 fied in paragraph (n) of subdivision one of this section for the period
27 January first, two thousand five through December thirty-first, two
28 thousand five, and up to thirty-one million dollars annually for the
29 period January first, two thousand six through December [thirty first]
30 thirty-first, two thousand [six] seven, and up to [fifteen] seven
31 million [five] seven hundred fifty thousand dollars for the period Janu-
32 ary first, two thousand [seven] eight through [June thirtieth] March
33 thirty-first, two thousand [seven] eight, shall be set aside and
34 reserved by the commissioner from the regional pools established pursu-
35 ant to subdivision two of this section for supplemental distributions in
36 each such region to be made by the commissioner to consortia and teach-
37 ing general hospitals in accordance with a distribution methodology
38 developed in consultation with the council and specified in rules and
39 regulations adopted by the commissioner.
40 § 20. Subdivision 7 of section 2807-m of the public health law, as
41 amended by section 48 of part B of chapter 58 of the laws of 2005, is
42 amended to read as follows:
43 7. Notwithstanding any inconsistent provision of section one hundred
44 twelve or one hundred sixty-three of the state finance law or any other
45 law, up to one million dollars for the period January first, two thou-
46 sand through December thirty-first, two thousand, up to one million six
47 hundred thousand dollars annually for the periods January first, two
48 thousand one through December thirty-first, two thousand [six] seven,
49 and up to [eight] four hundred thousand dollars for the period January
50 first, two thousand [seven] eight through [June thirtieth] March thir-
51 ty-first, two thousand [seven] eight, shall be set aside and reserved by
52 the commissioner from the regional pools established pursuant to subdi-
53 vision two of this section for distributions to the New York state area
54 health education center program for the purpose of expanding community-
55 based training of medical students. The New York state area health
56 education center program shall report to the commissioner on an annual
S. 2108--C 58 A. 4308--C
1 basis regarding the use of funds for such purpose in such form and
2 manner as specified by the commissioner.
3 § 21. Paragraph (c) of subdivision 2 of section 2807-s of the public
4 health law is amended by adding a new subparagraph (iv) to read as
5 follows:
6 (iv) The regional percentage allowance for periods on and after July
7 first, two thousand seven, for all general hospitals in the region
8 applicable to specified third-party payors, and applicable to related
9 patient coinsurance and deductible amounts, shall be the same regional
10 percentage allowance calculated pursuant to subparagraph (iii) of this
11 paragraph for the period January first, two thousand six through June
12 thirtieth, two thousand seven.
13 § 22. Paragraph (a) of subdivision 7 of section 2807-s of the public
14 health law, as amended by section 7 of part E of chapter 63 of the laws
15 of 2005, is amended to read as follows:
16 (a) funds shall be accumulated in regional professional education
17 pools established by the commissioner or the healthcare reform act
18 (HCRA) resources fund established pursuant to section ninety-two-dd of
19 the state finance law, whichever is applicable, for distribution in
20 accordance with section twenty-eight hundred seven-m of this article, in
21 the following amounts:
22 (i) ninety-two and forty-five-hundredths percent of the funds accumu-
23 lated less seventy-six million dollars for the period January first,
24 nineteen hundred ninety-seven through December thirty-first, nineteen
25 hundred ninety-seven,
26 (ii) ninety-two and forty-five-hundredths percent of the funds accumu-
27 lated less seventy-six million dollars for the period January first,
28 nineteen hundred ninety-eight through December thirty-first, nineteen
29 hundred ninety-eight,
30 (iii) ninety-two and forty-five-hundredths percent of the funds accu-
31 mulated less one hundred one million dollars for the period January
32 first, nineteen hundred ninety-nine through December thirty-first, nine-
33 teen hundred ninety-nine,
34 (iv) four hundred ninety-four million dollars on an annual basis for
35 the periods January first, two thousand through December thirty-first,
36 two thousand three,
37 (v) four hundred sixty-three million dollars for the period January
38 first, two thousand four through December thirty-first, two thousand
39 four,
40 (vi) four hundred eighty-eight million dollars for the period January
41 first, two thousand five through December thirty-first, two thousand
42 five,
43 (vii) four hundred ninety-four million dollars for the period January
44 first, two thousand six through December thirty-first, two thousand six,
45 (viii) [two hundred forty-seven] four hundred seventy million dollars
46 for the period January first, two thousand seven through [June thirti-
47 eth] December thirty-first, two thousand seven, and
48 (ix) one hundred twenty-three million five hundred thousand dollars
49 for the period January first, two thousand eight through March thirty-
50 first, two thousand eight;
51 (x) provided, however, amounts set forth in this paragraph may be
52 reduced by the commissioner in an amount to be approved by the director
53 of the budget to reflect the amount received from the federal government
54 under the state's 1115 waiver which is directed under its terms and
55 conditions to the graduate medical education program established pursu-
56 ant to section twenty-eight hundred seven-m of this article;
S. 2108--C 59 A. 4308--C
1 [(x)] (xi) provided further, however, amounts set forth in this para-
2 graph shall be reduced by an amount equal to the total actual distrib-
3 ution reductions for all facilities pursuant to paragraph (e) of subdi-
4 vision three of section twenty-eight hundred seven-m of this article;
5 and
6 [(xi)] (xii) provided further, however, amounts set forth in this
7 paragraph shall be reduced by an amount equal to the actual distribution
8 reductions for all facilities pursuant to paragraph (l) of subdivision
9 one of section twenty-eight hundred seven-m of this article.
10 § 23. Subdivision 1 of section 2807-c of the public health law is
11 amended by adding two new paragraphs (i) and (j) to read as follows:
12 (i) For the period July first, two thousand seven through March thir-
13 ty-first, two thousand eight, contingent upon the availability of feder-
14 al financial participation:
15 (i) The commissioner shall adjust inpatient medical assistance rates
16 of payment calculated pursuant to this section for public hospitals
17 other than non-state public hospitals located in a city with a popu-
18 lation of more than one million persons, that meet the targeted medicaid
19 discharge percentage in accordance with the methodology set forth in
20 subparagraph (ii) of this paragraph. For purposes of this paragraph,
21 "targeted medicaid discharge percentage" shall mean that at least seven-
22 teen and one-half percent of a public hospital's total discharges were
23 patients eligible for payments under the medical assistance program
24 pursuant to title eleven of article five of the social services law,
25 including those enrolled in health maintenance organizations, and
26 patients eligible for payments under the family health plus program
27 pursuant to title eleven-D of article five of the social services law,
28 based on data reported in such hospital's institutional cost report
29 submitted for the two thousand four period and filed with the department
30 by November first, two thousand six.
31 (ii) The aggregate amount of rate adjustments calculated pursuant to
32 this paragraph shall not exceed six million dollars in the aggregate.
33 Such amount shall be allocated proportionally based on the relative
34 numbers of medicaid discharges among those public hospitals eligible for
35 rate adjustments in accordance with subparagraph (i) of this paragraph
36 based on each such hospital's reported medical assistance data specified
37 in subparagraph (i) of this paragraph. Such amounts shall be included as
38 an add-on to medical assistance inpatient rates of payment, excluding
39 exempt unit rates, and shall not be reconciled to reflect changes in
40 medical assistance utilization between two thousand four and the current
41 rate year.
42 (j) For the period July first, two thousand seven through March thir-
43 ty-first, two thousand eight, contingent upon the availability of
44 federal financial participation:
45 (i) The commissioner shall adjust inpatient medical assistance rates
46 of payment calculated pursuant to this section for voluntary hospitals
47 other than voluntary hospitals located in a city with a population of
48 more than one million persons that meet the targeted medicaid discharge
49 percentage in accordance with the methodology set forth in subparagraph
50 (ii) of this paragraph. For purposes of this paragraph, "targeted Medi-
51 caid discharge percentage" shall mean between seventeen and one-half
52 percent and thirty-five percent of a voluntary hospital's total
53 discharges were patients eligible for payments under the medical
54 assistance program pursuant to title eleven of article five of the
55 social services law, including those enrolled in health maintenance
56 organizations, and patients eligible for payments under the family
S. 2108--C 60 A. 4308--C
1 health plus program pursuant to title eleven-D of article five of the
2 social services law, based on data reported in such hospital's institu-
3 tional cost report submitted for the two thousand four period and filed
4 with the department by November first, two thousand six.
5 (ii) The aggregate amount of rate adjustments calculated pursuant to
6 this paragraph shall not exceed forty-two million dollars. Such amount
7 shall be allocated proportionally based on relative numbers of medicaid
8 discharges among those voluntary hospitals eligible for rate adjustments
9 in accordance with subparagraph (i) of this paragraph based on each
10 such hospital's reported medical assistance data specified in subpara-
11 graph (i) of this paragraph. Such amounts shall be included as an add-on
12 to medical assistance inpatient rates of payment, excluding exempt unit
13 rates, and shall not be reconciled to reflect changes in medical assist-
14 ance utilization between two thousand four and the rate year.
15 § 24. Subdivisions 3, 4 and 5 of section 47 of chapter 2 of the laws
16 of 1998, amending the public health law and other laws relating to
17 expanding the child health insurance plan, as amended by section 15 of
18 part B of chapter 58 of the laws of 2005, are amended to read as
19 follows:
20 3. section six of this act shall take effect January 1, 1999;
21 provided, however, that subparagraph (iii) of paragraph (c) of subdivi-
22 sion 9 of section 2510 of the public health law, as added by this act,
23 shall expire on July 1, [2007] 2011;
24 4. sections two, three, four, seven, eight, nine, fourteen, fifteen,
25 sixteen, eighteen, eighteen-a, twenty-three, twenty-four, and twenty-
26 nine of this act shall take effect January 1, 1999 and shall expire on
27 July 1, [2007] 2011; section twenty-five of this act shall take effect
28 on January 1, 1999 and shall expire on April 1, 2005;
29 5. section twelve of this act shall take effect January 1, 1999;
30 provided, however, paragraphs (g) and (h) of subdivision 2 of section
31 2511 of the public health law, as added by such section, shall expire on
32 July 1, [2007] 2011;
33 § 25. Intentionally Omitted
34 § 26. Paragraph (c) of subdivision 9 of section 2510 of the public
35 health law, as added by chapter 2 of the laws of 1998, subparagraph (i)
36 as amended by chapter 419 of the laws of 2000, is amended to read as
37 follows:
38 (c) for periods on or after January first, nineteen hundred ninety-
39 nine, amounts as follows:
40 (i) no payments are required for eligible children whose family net
41 household income is less than one hundred thirty-three percent of the
42 non-farm federal poverty level or the gross equivalent of such net
43 income and, effective August first, two thousand, no payments are
44 required for eligible children who are American Indians or Alaskan
45 Natives, as defined by the U.S. Department of Health and Human Services;
46 and
47 (ii) nine dollars per month for each eligible child whose family net
48 household income is between one hundred thirty-three percent and one
49 hundred eighty-five percent of the non-farm federal poverty level or the
50 gross equivalent of such net income, but no more than twenty-seven
51 dollars per month per family; and
52 (iii) fifteen dollars per month for each eligible child whose family
53 net household income is between one hundred eighty-six percent and one
54 hundred ninety-two percent of the non-farm federal poverty level or the
55 gross equivalent of such net income, but no more than forty-five dollars
56 per month per family, and, effective July first, two thousand, fifteen
S. 2108--C 61 A. 4308--C
1 dollars per month for each eligible child whose family net household
2 income is between one hundred eighty-six percent and two hundred eight
3 percent of the non-farm federal poverty level or the gross equivalent of
4 such net income, but no more than forty-five dollars per month per fami-
5 ly[.]; and
6 (iv) effective September first, two thousand seven, contingent upon
7 the availability of federal financial participation for the income
8 expansion set forth in subparagraph (iii) of paragraph (a) of subdivi-
9 sion two of section twenty-five hundred eleven of this article, twenty
10 dollars per month for each eligible child whose family gross household
11 income is between two hundred fifty-one percent and three hundred
12 percent of the non-farm federal poverty level, but no more than sixty
13 dollars per month per family;
14 (v) effective September first, two thousand seven, contingent upon the
15 availability of federal financial participation for the income expansion
16 set forth in subparagraph (iii) of paragraph (a) of subdivision two of
17 section twenty-five hundred eleven of this article, thirty dollars per
18 month for each eligible child whose family gross household income is
19 between three hundred one percent and three hundred fifty percent of the
20 non-farm federal poverty level, but no more than ninety dollars per
21 month per family; and
22 (vi) effective September first, two thousand seven, contingent upon
23 the availability of federal financial participation for the income
24 expansion set forth in subparagraph (iii) of paragraph (a) of subdivi-
25 sion two of section twenty-five hundred eleven of this article, forty
26 dollars per month for each eligible child whose family gross household
27 income is between three hundred fifty-one percent and four hundred
28 percent of the non-farm federal poverty level, but no more than one
29 hundred twenty dollars per month per family.
30 § 27. Section 2510 of the public health law is amended by adding a new
31 subdivision 12 to read as follows:
32 12. "Group health plan" or "health insurance coverage" shall have the
33 same meanings as set forth in section twenty-one hundred ten of the
34 federal social security act.
35 § 28. Subparagraph (ii) of paragraph (a) of subdivision 2 of section
36 2511 of the public health law, as amended by chapter 2 of the laws of
37 1998, is amended and a new subparagraph (iii) is added to read as
38 follows:
39 (ii) effective July first, two thousand, resides in a household having
40 a [net] gross household income at or below two hundred [eight] fifty
41 percent of the non-farm federal poverty level (as defined and updated by
42 the United States department of health and human services) [or the gross
43 equivalent of such net income]; and
44 (iii) effective September first, two thousand seven, contingent upon
45 the availability of federal financial participation, resides in a house-
46 hold having a gross household income at or below four hundred percent of
47 the non-farm federal poverty level (as defined and updated by the United
48 States department of health and human services);
49 § 29. Paragraph (g) of subdivision 2 of section 2511 of the public
50 health law, as added by chapter 2 of the laws of 1998 and subparagraph
51 (i) as amended by chapter 419 of the laws of 2000, is amended to read as
52 follows:
53 (g) (i) Notwithstanding any inconsistent provision of law to the
54 contrary and subject to the availability of federal financial partic-
55 ipation under title XIX of the federal social security act, a child
56 under the age of nineteen shall be presumed to be eligible for subsidy
S. 2108--C 62 A. 4308--C
1 payments and temporarily enrolled for coverage under this title, once
2 during a twelve month period, beginning on the first day of the enroll-
3 ment period following the date that an approved organization determines,
4 on the basis of preliminary information, that a [child whose family's]
5 child's net household income does not exceed [one hundred ninety-two
6 percent or, effective July first, two thousand, two hundred eight
7 percent of the non-farm federal poverty level or the gross equivalent of
8 such net income] the income level specified in title eleven of article
9 five of the social services law for children eligible for medical
10 assistance based on such child's age. The [presumptive eligibility]
11 temporary enrollment period shall continue until the earlier of the date
12 an eligibility determination is made pursuant to this title or title
13 eleven of article five of the social services law, or two months after
14 the date [presumptive eligibility] temporary enrollment begins; provided
15 however, a [presumptive eligibility] temporary enrollment period may be
16 extended in the event an eligibility determination under this title or
17 title eleven of article five of the social services law is not made
18 within such two month period through no fault of the applicant for
19 insurance for medical assistance. The commissioner shall assure that
20 children who are enrolled pursuant to this paragraph receive the appro-
21 priate follow-up for a determination of eligibility for benefits under
22 this title or title eleven of article five of the social services law
23 prior to the termination of the [presumptive eligibility] temporary
24 enrollment period. The commissioner shall assure that children and their
25 families are informed of all available enrollment sites in accordance
26 with subdivision nine of this section.
27 (ii) [This paragraph shall have no force and effect and presumptive
28 eligibility under this paragraph shall not be available on and after the
29 date presumptive eligibility in the medical assistance program becomes
30 effective and is available pursuant to subdivision four of section three
31 hundred sixty-four-i and paragraph (u) of subdivision four of section
32 three hundred sixty-six of the social services law] Effective September
33 first, two thousand seven, temporary enrollment pursuant to subparagraph
34 (i) of this paragraph shall be provided only to children who apply for
35 recertification of coverage under this title who appear to be eligible
36 for medical assistance under title eleven of article five of the social
37 services law.
38 § 29-a. Subdivision 4 of section 364-i of the social services law is
39 REPEALED and a new subdivision 4 is added to read as follows:
40 4. (a) Notwithstanding any inconsistent provision of law to the
41 contrary, a child shall be presumed to be eligible for medical assist-
42 ance under this title beginning on the date that a qualified entity, as
43 defined in paragraph (c) of this subdivision, determine, on the basis of
44 preliminary information, that the net household income of the child does
45 not exceed the applicable level for eligibility as provided for pursuant
46 to paragraph (u) of subdivision four of section three hundred sixty-six
47 of this title.
48 (b) Such presumptive eligibility shall continue through the earlier of
49 the day on which eligibility is determined pursuant to this title, or in
50 the case of a child on whose behalf an application is not filed by the
51 last day of the month following the month during which the qualified
52 entity makes a preliminary determination, the last day of the month
53 following the month in which the qualified entity makes a determination
54 in paragraph (a) of this subdivision.
55 (c) For the purposes of this subdivision, and consistent with the
56 applicable provisions of section 1920A of the federal social security
S. 2108--C 63 A. 4308--C
1 act, "qualified entity" means an entity determined by the department of
2 health to be capable of making presumptive eligibility determinations.
3 (d) Notwithstanding any inconsistent provision of law to the contrary,
4 care, services and supplies, as set forth in section three hundred
5 sixty-five-a of this title, that are furnished to a child during a
6 presumptive eligibility period by an entity that is eligible for
7 payments under this title shall be deemed to be medical assistance for
8 purposes of payment and state and federal reimbursement.
9 (e) Presumptive eligibility pursuant to this subdivision shall be
10 implemented effective December first, two thousand seven contingent upon
11 a determination by the commissioner of health that all necessary systems
12 and processes are in place to enroll children appropriately in accord-
13 ance with the requirements set forth in this title; provided, however,
14 presumptive eligibility pursuant to this subdivision shall be imple-
15 mented no later than April first, two thousand eight.
16 § 29-b. Paragraph (u) of subdivision 4 of section 366 of the social
17 service law is REPEALED and a new paragraph (u) is added to read as
18 follows:
19 (u) (1) Notwithstanding the provisions of paragraph (p) of this subdi-
20 vision, children who are less than one year of age and have a net house-
21 hold income less than or equal to two hundred percent of the federal
22 income official poverty line (as defined and updated by the United
23 States department of health and human services) for a family of the same
24 size as the families that include children shall be eligible for
25 presumptive eligibility in accordance with subdivision four of section
26 three hundred sixty-four-i of this title.
27 (2) Notwithstanding the provisions of paragraph (p) of this subdivi-
28 sion, children who are at least one year of age and less than six years
29 and have a net household income less than or equal to one hundred thir-
30 ty-three percent of the federal income official poverty line (as defined
31 and updated by the United States department of health and human
32 services) for a family of the same size as the families that include the
33 children shall be eligible in accordance with subdivision four of
34 section three hundred sixty-four-i of this title.
35 (3) Notwithstanding the provisions of paragraph (q) of this subdivi-
36 sion, children who are at least six years of age and younger than nine-
37 teen years and have a net household income less than or equal to one
38 hundred percent of the federal official poverty line (as defined and
39 updated by the United States department of health and human services)
40 for a family of the same size as the families that include the children
41 shall be eligible in accordance with subdivision four of section three
42 hundred sixty-four-i of this title.
43 (4) For the purposes of determining eligibility for medical assistance
44 under this paragraph, family income shall be determined in accordance
45 with subparagraph two of paragraph (p) of this subdivision.
46 § 29-c. From September 1, 2007 to the effective date of presumptive
47 eligibility in medical assistance pursuant to sections twenty-nine-a and
48 twenty-nine-b of this act, the commissioner of health shall monitor the
49 compliance of the local departments of social services in meeting the
50 timeframes for determination of children's eligibility and provide regu-
51 lar reports to the legislature.
52 § 30. Subdivision 7-a of section 2511 of the public health law is
53 amended by adding a new paragraph (d) to read as follows:
54 (d) Notwithstanding any inconsistent provision of section one hundred
55 twelve or one hundred sixty-three of the state finance law, at the
56 discretion of the commissioner, without a competitive bid or request for
S. 2108--C 64 A. 4308--C
1 proposal process, contractual arrangements with approved organizations,
2 as defined in subdivision two of section twenty-five hundred ten of this
3 article, in effect in two thousand seven may be extended to any period
4 on and after July first, two thousand seven to provide an uninterrupted
5 continuation of services and may be amended as deemed necessary.
6 § 30-a. Notwithstanding any inconsistent provision of section 112 or
7 163 of the state finance law, at the discretion of the commissioner of
8 health, without a competitive bid or request for proposal process,
9 contractual arrangements with outreach and facilitated enrollment
10 contractors pursuant to subdivision 9 of section 2511 of the public
11 health law in effect in two thousand seven may be extended to December
12 31, 2011 to provide an uninterrupted continuation of services and may be
13 amended as deemed necessary.
14 § 31. Section 2511 of the public health law is amended by adding a new
15 subdivision 18 to read as follows:
16 18. Premium Assistance Program. (a) The commissioner shall establish a
17 premium assistance program for the purchase of family coverage under a
18 group health plan or health insurance coverage that includes coverage of
19 an eligible child, as defined in subdivision four of section twenty-five
20 hundred ten of this article, contingent upon:
21 (i) a determination by the commissioner that the purchase of family
22 coverage under this subdivision is cost effective relative to the amount
23 the state would pay to obtain coverage under this title solely for the
24 eligible child or children; and
25 (ii) the availability of federal financial participation in accordance
26 with a waiver application submitted by the commissioner and approved by
27 the secretary of the department of health and human services.
28 (b) The commissioner shall establish and specify standards for the
29 implementation of the premium assistance program in the federal waiver
30 application, including, but not limited to, the following:
31 (i) standards for eligibility of children and families for and enroll-
32 ment in the premium assistance program which shall include, at a mini-
33 mum, the eligibility criteria set forth in subdivision two of this
34 section; provided that:
35 (A) participation in the program for a child who resides in a house-
36 hold having a gross household income at or below two hundred fifty
37 percent of the non-farm federal poverty level (as defined and updated by
38 the United States department of health and human services) shall be
39 voluntary and an eligible child may disenroll from the premium assist-
40 ance program at any time and enroll in individual coverage under this
41 title; and
42 (B) participation in the program for a child who resides in a house-
43 hold having a gross household income between two hundred fifty-one and
44 four hundred percent of the non-farm federal poverty level (as defined
45 and updated by the United States department of health and human
46 services) and meets certain eligibility criteria shall be mandatory. A
47 child in this income group who meets the criteria for enrollment in the
48 premium assistance program shall not be eligible for individual coverage
49 under this title;
50 (ii) standards for required levels of employer contributions toward
51 the cost of premiums for family coverage;
52 (iii) standards for the level of state payment toward the cost of
53 premiums for family coverage;
54 (iv) standards for the scope and level of benefits to be provided in
55 the premium assistance program;
S. 2108--C 65 A. 4308--C
1 (v) standards for data collection including, but not limited to, data
2 regarding the substitution of health insurance coverage that would be
3 provided to eligible children in the absence of family coverage
4 purchased pursuant to this subdivision; and
5 (vi) any other standards deemed necessary by the commissioner to
6 implement the premium assistance program.
7 (c) The state share of the cost of the premium assistance program, if
8 implemented, shall be funded within amounts appropriated for the purpose
9 of providing healthcare coverage for uninsured and underinsured children
10 pursuant to this title.
11 § 32. Clauses (F) and (G) of subparagraph (i) of paragraph (d) of
12 subdivision 2 of section 2511 of the public health law, as added by
13 chapter 2 of the laws of 1998, are amended and three new clauses (H),
14 (I) and (J) are added to read as follows:
15 (F) expiration of the coverage periods established by COBRA or the
16 provisions of subsection (m) of section three thousand two hundred twen-
17 ty-one, subsection (k) of section four thousand three hundred four and
18 subsection (e) of section four thousand three hundred five of the insur-
19 ance law; [or]
20 (G) termination of comprehensive health benefits coverage due to long-
21 term disability[.];
22 (H) cost of employment-based health insurance is more than five
23 percent of the family's income;
24 (I) a child applying for coverage under this title is pregnant; or
25 (J) a child applying for coverage under this title is at or below the
26 age of five. Implementation of this exception is subject to federal
27 approval of the state's child health plan setting forth such exception
28 and submitted in accordance with Title XXI of the federal social securi-
29 ty act. If federal approval is not granted to implement this exception
30 for children at or below the age of five, such exception shall be imple-
31 mented at an alternate age specified by the federal government and
32 included in the state's Title XXI child health plan.
33 § 33. Subparagraph (ii) of paragraph (d) of subdivision 2 of section
34 2511 of the public health law, as added by chapter 2 of the laws of
35 1998, is amended to read as follows:
36 (ii) (A) The implementation of this paragraph for a child residing in
37 a household having a gross household income at or below two hundred
38 fifty percent of the non-farm federal poverty level (as defined and
39 updated by the United States department of health and human services)
40 shall take effect only upon the commissioner's finding that insurance
41 provided under this title is substituting for coverage under group
42 health plans in excess of a percentage specified by the secretary of the
43 federal department of health and human services. The commissioner shall
44 notify the legislature prior to implementation of this paragraph.
45 (B) Contingent upon the availability of federal financial partic-
46 ipation for the income expansion set forth in subparagraph (iii) of
47 paragraph (a) of this subdivision, the implementation of this paragraph
48 for a child residing in a household having a gross household income
49 between two hundred fifty-one and four hundred percent of the non-farm
50 federal poverty level (as defined and updated by the United States
51 department of health and human services) shall take effect September
52 first, two thousand seven. The commissioner shall monitor the number of
53 children who are subject to the waiting period established pursuant to
54 this clause.
55 § 34. Subdivision 5 of section 2511 of the public health law, as
56 amended by chapter 2 of the laws of 1998, is amended to read as follows:
S. 2108--C 66 A. 4308--C
1 5. Notwithstanding any inconsistent provisions of subdivision two of
2 this section, an individual who meets the criteria of paragraphs
3 [(b)and] (b) and (c) of subdivision two of this section but not the
4 criteria of paragraph (a) of such subdivision may be enrolled for
5 covered health care services, provided however, that an approved organ-
6 ization shall not be eligible to receive a subsidy payment for providing
7 coverage to such individuals. The cost of coverage shall be determined
8 by the commissioner, in consultation with the superintendent and shall
9 be no more than the cost of providing such coverage.
10 § 35. Intentionally Omitted
11 § 36. Subdivision 8 of section 2511 of the public health law, as
12 amended by section 17 of part B of chapter 58 of the laws of 2005, is
13 amended to read as follows:
14 8. The commissioner shall determine the amount of funds to be allo-
15 cated to an approved organization for the purposes described in subdivi-
16 sion one of this section within such funds which may be available for
17 the purposes of this article. (a) Subsidy payments made to approved
18 organizations on and after April first, two thousand five through March
19 thirty-first, two thousand six, shall be at amounts approved prior to
20 April first, two thousand five. Applications for increases to subsidy
21 payments submitted by approved organizations to the superintendent on or
22 after January first, two thousand five, shall not be considered for
23 approval until after March thirty-first, two thousand six. (b) Further,
24 subsidy payments made to approved organizations on and after April
25 first, two thousand seven through March thirty-first, two thousand
26 eight, shall be at amounts approved prior to April first, two thousand
27 seven. Applications for increases to subsidy payments submitted by
28 approved organizations to the superintendent on or after January first,
29 two thousand seven, shall not be considered for approval until after
30 March thirty-first, two thousand eight. (c) Nothing in this subdivision
31 shall prohibit decreases in subsidy payments in accordance with relevant
32 contract provisions.
33 § 37. Subdivision 11 of section 2511 of the public health law, as
34 amended by chapter 2 of the laws of 1998, is amended to read as follows:
35 11. (a) An approved organization shall submit required reports and
36 information to the commissioner in such form and at times, at least
37 annually, as may be required by the commissioner and specified in
38 contracts and official department of health administrative guidance, in
39 order to evaluate the operations and results of the program and quality
40 of care being provided by such organizations. Such reports and informa-
41 tion shall include, but not be limited to, enrollee demographics,
42 program utilization and expense, [and] patient care outcomes and patient
43 specific medical information, including encounter data maintained by an
44 approved organization for purposes of quality assurance and oversight.
45 Any information or data collected pursuant to this paragraph shall be
46 kept confidential in accordance with Title XXI of the federal social
47 security act or any other applicable state or federal law.
48 (b) In the event an approved organization fails to submit any required
49 report and information, as specified in contracts and official depart-
50 ment of health administrative guidance, on or before the due date speci-
51 fied by the commissioner, the commissioner may reduce the approved
52 organization's subsidy payments by up to a total of two percent each
53 month for a period beginning on the first day of the calendar month
54 following the original due date of the required report and information
55 and continuing until the last day of the calendar month in which the
56 required report and information are submitted; provided however, an
S. 2108--C 67 A. 4308--C
1 approved organization shall not be subject to the percentage reduction
2 under the following conditions: [(a)] (i) for any new report for which
3 such organization did not have reasonable notice which shall be at least
4 sixty days notice of its requirement, data and submission specifica-
5 tions, and due date by certified mail to the approved organization's
6 chief financial officer; or [(b)] (ii) for any report, upon a finding by
7 the commissioner that such report was not submitted on a timely basis
8 for good cause, which may include, but not be limited to, additional
9 time required to modify or add to computer data systems.
10 § 37-a. Paragraph (a-2) of subdivision 1 of section 2807-c of the
11 public health law, as added by chapter 639 of the laws of 1996, is
12 amended to read as follows:
13 (a-2) (i) With the exception of those enrollees covered under a
14 payment rate methodology agreement negotiated with a general hospital,
15 payments for inpatient hospital services provided to patients eligible
16 for medical assistance pursuant to title eleven of article five of the
17 social services law made by organizations operating in accordance with
18 the provisions of article forty-four of this chapter or by health main-
19 tenance organizations organized and operating in accordance with article
20 forty-three of the insurance law shall be the rates of payment that
21 would be paid for such patients under the medical assistance program,
22 (i) determined pursuant to this section, excluding adjustments pursuant
23 to subdivision fourteen-f of this section, and (ii) excluding medical
24 education costs that are reimbursed directly to the general hospital in
25 accordance with paragraph (a-3) of this subdivision.
26 (ii) Effective July first, two thousand seven, with the exception of
27 those enrollees covered under a payment rate methodology agreement nego-
28 tiated with a general hospital, payment for inpatient hospital services
29 provided to patients enrolled in the child health insurance program
30 pursuant to title one-A of article twenty-five of this chapter made by
31 organizations operating in accordance with the provisions of article
32 forty-four of this chapter or by health maintenance organizations organ-
33 ized and operating in accordance with article forty-three of the insur-
34 ance law shall be the rates of payment that would be paid under the
35 medical assistance program determined pursuant to this section, exclud-
36 ing adjustments pursuant to subdivision fourteen-f of this section.
37 § 38. Paragraph (e) of subdivision 2 of section 4 of section 1 of
38 chapter 703 of the laws of 1988, relating to enacting the expanded
39 health care coverage act of nineteen hundred eighty-eight and amending
40 the insurance law and other laws relating to expanded health care and
41 catastrophic health care coverage, as amended by section 21 of part B of
42 chapter 58 of the laws of 2005, is amended to read as follows:
43 (e) Applications for enrollment in the individual subsidy program will
44 not be accepted on and after January first, two thousand one; provided,
45 however, individuals and families who are otherwise eligible to receive
46 benefits under such program and are enrolled prior to January first, two
47 thousand one, may remain enrolled in such program until [December] March
48 thirty-first, two thousand [seven] eight.
49 § 39. The opening paragraph of section 2952 of the public health law,
50 as amended by section 24 of part B of chapter 58 of the laws of 2005, is
51 amended to read as follows:
52 To the extent of funds available therefor, the sum of seven million
53 dollars shall annually be available for periods prior to January first,
54 two thousand three, and up to six million five hundred thirty thousand
55 dollars annually for the period January first, two thousand three
56 through December thirty-first, two thousand four, up to seven million
S. 2108--C 68 A. 4308--C
1 sixty-two thousand dollars for the period January first, two thousand
2 five through December thirty-first, two thousand six annually, [and] up
3 to [three] seven million [five hundred thirty-one] sixty-two thousand
4 dollars for the period January first, two thousand seven through [June
5 thirtieth] December thirty-first, two thousand seven, and up to one
6 million seven hundred sixty-six thousand dollars for the period January
7 first, two thousand eight through March thirty-first, two thousand
8 eight, shall be available to the commissioner from funds made available
9 pursuant to section twenty-eight hundred seven-l of this chapter for
10 grants pursuant to this section.
11 § 40. Subdivision 1 of section 2958 of the public health law, as
12 amended by section 25 of part B of chapter 58 of the laws of 2005, is
13 amended to read as follows:
14 1. To the extent of funds available therefor, the sum of ten million
15 dollars shall annually be made available for periods prior to January
16 first, two thousand three, and up to nine million three hundred twenty
17 thousand dollars for the period January first, two thousand three
18 through December thirty-first, two thousand three, up to nine million
19 three hundred twenty thousand dollars for the period January first, two
20 thousand four through December thirty-first, two thousand four, up to
21 twelve million eighty-eight thousand dollars for the period January
22 first, two thousand five through December thirty-first, two thousand
23 five, up to twelve million eighty-eight thousand dollars for the period
24 January first, two thousand six through December thirty-first, two thou-
25 sand six, [and] up to [five] eleven million [five hundred forty-four]
26 eighty-eight thousand dollars for the period January first, two thousand
27 seven through [June thirtieth] December thirty-first, two thousand
28 seven, and up to two million seven hundred seventy-two thousand dollars
29 for the period January first, two thousand eight through March thirty-
30 first, two thousand eight, shall be available to the commissioner from
31 funds pursuant to section twenty-eight hundred seven-l of this chapter
32 to provide assistance to general hospitals classified as a rural hospi-
33 tal for purposes of determining payment for inpatient services provided
34 to beneficiaries of title XVIII of the federal social security act
35 (Medicare) or under state regulations, in recognition of the unique
36 costs incurred by these facilities to provide hospital services in
37 remote or sparsely populated areas pursuant to subdivision two of this
38 section.
39 § 41. Subdivision 5 of section 367-o of the social services law, as
40 separately amended by sections 4 and 98 of part B of chapter 58 of the
41 laws of 2005, is amended to read as follows:
42 5. Between January first, two thousand and December thirty-first, two
43 thousand two, the state share amount for all demonstrations pursuant to
44 this section shall be no more than twenty-seven million dollars per
45 twelve month period if averaged over the term of the demonstration; and
46 between January first, two thousand three and June thirtieth, two thou-
47 sand seven, the state share amount for all demonstrations pursuant to
48 this section shall be no more than sixty-nine million dollars per twelve
49 month period if averaged over the term of the demonstration and between
50 July first, two thousand seven and March thirty-first, two thousand
51 eight, the state share of medical assistance payments authorized in
52 accordance with subdivision two of this section shall not exceed two
53 million eight hundred fifty thousand dollars.
54 § 42. Section 367-o of the social services law is amended by adding a
55 new subdivision 3-a to read as follows:
S. 2108--C 69 A. 4308--C
1 3-a. (a) Notwithstanding subdivision three of this section or any
2 other contrary provision of law and subject to the availability of
3 federal financial participation, the commissioner of health shall, for
4 periods on and after July first, two thousand seven, and within amounts
5 appropriated, adjust rates of payments for certified home health agen-
6 cies and providers of personal care services who, (i) are located in a
7 city with a population of over one million persons, or in a county with
8 a population of over nine hundred thousand persons if such county is
9 located within the metropolitan commuter transportation district created
10 pursuant to section twelve hundred sixty-two of the public authorities
11 law; and (ii) provide more than fifty percent of their total annual
12 hours of home care services to recipients of medical assistance; and
13 (iii) contribute, as of July first, two thousand seven, to a group
14 health insurance plan or employer based group health plan on behalf of
15 their employees.
16 (b) Payments made pursuant to this subdivision to eligible providers
17 shall be made proportionally in the form of an add-on to rates of
18 payment, based on each eligible provider's most currently available
19 total annual hours of home care services, as reported to the department,
20 provided to recipients of medical assistance.
21 (c) Providers which have their rates of payment adjusted pursuant to
22 this subdivision shall use such funds solely for the purpose of support-
23 ing health insurance coverage for their employees and are prohibited
24 from using such funds for any other purpose. The commissioner of health
25 is authorized to audit such providers for the purpose of ensuring
26 compliance with the provisions of this paragraph and shall recoup any
27 funds determined to have been used for purposes other than as authorized
28 by this subdivision.
29 § 43. Subdivision 18 of section 2808 of the public health law, as
30 amended by section 46 of part J of chapter 82 of the laws of 2002,
31 clause (A) of subparagraph (i) of paragraph (a) as amended by section 10
32 and clause (A) of subparagraph (i) of paragraph (b) as amended by
33 section 11 of part B of chapter 58 of the laws of 2005, is amended to
34 read as follows:
35 18. Residential health care facility recruitment and retention of
36 health care workers. Notwithstanding any inconsistent provision of law,
37 rule or regulation and subject to the availability of federal financial
38 participation:
39 (a) (i) The commissioner shall adjust inpatient medical assistance
40 rates of payment established pursuant to this article for non-public
41 residential health care facilities in accordance with subparagraph (ii)
42 of this paragraph for purposes of recruitment and retention of health
43 care workers in the following aggregate amounts for the following peri-
44 ods:
45 (A) fifty-three million five hundred thousand dollars on an annualized
46 basis for the period April first, two thousand two through December
47 thirty-first, two thousand two; eighty-three million three hundred thou-
48 sand dollars on an annualized basis for the period January first, two
49 thousand three through December thirty-first, two thousand three; one
50 hundred fifteen million eight hundred thousand dollars on an annualized
51 basis for the period January first, two thousand four through December
52 thirty-first, two thousand six; [and] fifty-seven million nine hundred
53 thousand dollars for the period January first, two thousand seven
54 through June thirtieth, two thousand seven, fifty-seven million nine
55 hundred thousand dollars for the period July first, two thousand seven
56 through March thirty-first, two thousand eight, and thirty-eight million
S. 2108--C 70 A. 4308--C
1 six hundred thousand dollars for the period April first, two thousand
2 eight through March thirty-first, two thousand nine.
3 (ii) Such increases shall be allocated proportionally based on each
4 non-public residential health care facility's reported total gross sala-
5 ry and fringe benefit costs on exhibit H of the 1999 RHCF - 4 cost
6 report or exhibit 11 of the 1999 institutional cost report submitted as
7 of November first, two thousand one, where applicable, to the total of
8 such reported costs for all non-public residential health care facili-
9 ties, provided, however, that for periods on and after July first, two
10 thousand seven, fifty percent of such increases shall be allocated
11 proportionally, based on each non-public residential health care facili-
12 ty's reported total gross salary and fringe benefit costs on exhibit H
13 of the nineteen hundred ninety-nine RHFC - 4 cost report or exhibit 11
14 of the nineteen hundred ninety-nine institutional cost report submitted
15 to the department prior to November first, two thousand one, where
16 applicable, to the total of such reported costs for all non-public resi-
17 dential health care facilities, and fifty percent of such increases
18 shall be allocated proportionately, based on each such non-public facil-
19 ity's reported Medicaid revenue, as reported in the applicable two thou-
20 sand five cost report as submitted to the department prior to November
21 first, two thousand six, to the total of such Medicaid revenue reported
22 by all such non-public facilities. These amounts shall be included as a
23 reimbursable cost add-on to medical assistance inpatient rates of
24 payment established pursuant to this article for non-public residential
25 health care facilities, based on medical assistance utilization data in
26 each facility's annual cost report submitted two years prior to the rate
27 year. Such amounts shall not be reconciled to reflect changes in medical
28 assistance utilization between the year two years prior to the rate year
29 and the rate year.
30 (b) (i) Notwithstanding sections one hundred twelve and one hundred
31 sixty-three of the state finance law and any other inconsistent
32 provision of law, the commissioner shall make grants to public residen-
33 tial health care facilities without a competitive bid or request for
34 proposal process for purposes of recruitment and retention of health
35 care workers in the following aggregate amounts for the following peri-
36 ods:
37 (A) seven million five hundred thousand dollars on an annualized basis
38 for the period April first, two thousand two through December thirty-
39 first, two thousand two; eleven million seven hundred thousand dollars
40 on an annualized basis for the period January first, two thousand three
41 through December thirty-first, two thousand three; sixteen million two
42 hundred thousand dollars on an annualized basis for the period January
43 first, two thousand four through December thirty-first, two thousand
44 six; and eight million one hundred thousand dollars for the period Janu-
45 ary first, two thousand seven through June thirtieth, two thousand
46 seven, eight million one hundred thousand dollars for the period July
47 first, two thousand seven through March thirty-first, two thousand
48 eight, and five million four hundred thousand dollars for the period
49 April first, two thousand eight through March thirty-first, two thousand
50 nine.
51 (ii) Such grants shall be allocated proportionally based on each
52 public residential health care facility's reported total gross salary
53 and fringe benefit costs on exhibit H of the 1999 RHCF - 4 cost report
54 or exhibit 11 of the 1999 institutional cost report submitted as of
55 November first, two thousand one, where applicable, to the total of such
56 reported costs for all public residential health care facilities.
S. 2108--C 71 A. 4308--C
1 (c) (i) Non-public and public residential health care facilities in
2 operation as of the effective date of this paragraph which have not
3 submitted 1999 RHCF-4 cost reports or 1999 institutional cost reports
4 but which have submitted such reports for cost years subsequent to 1999,
5 shall have distributions authorized in subparagraph (i) of paragraph (a)
6 of this subdivision or in subparagraph (i) of paragraph (b) of this
7 subdivision allocated based on total gross salary and fringe benefit
8 costs on exhibit H of the earliest subsequently submitted RHCF-4 cost
9 report or exhibit 11 of the earliest subsequently submitted institu-
10 tional cost report, as trended downward to 1999 using trend factors
11 authorized in accordance with the provisions of section twenty-one of
12 chapter one of the laws of nineteen hundred ninety-nine.
13 (ii) Non-public and public residential health care facilities in oper-
14 ation as of the effective date of this paragraph which have not submit-
15 ted 1999 or subsequent RHCF-4 cost reports or institutional cost
16 reports, shall have distributions authorized in subparagraph (i) of
17 paragraph (a) of this subdivision or in subparagraph (i) of paragraph
18 (b) of this subdivision allocated based on imputed total gross salary
19 and fringe benefit costs reflecting the average of such costs in the
20 region in which each such facility is located, provided, however, that
21 for periods on and after July first, two thousand seven, facilities that
22 have not submitted two thousand five cost reports shall have distrib-
23 utions allocated based on imputed days of care to patients eligible for
24 medical assistance, reflecting the average of such medicaid days of care
25 in the region in which such facilities are located.
26 § 43-a. Notwithstanding paragraph (a) of subdivision 18 of section
27 2808 of the public health law or any other contrary provision of law, in
28 the event the commissioner of health, with the approval of the director
29 of the budget, determines that federal financial participation will not
30 be available for Medicaid rate increases for periods on and after July
31 1, 2007, pursuant to the distribution methodology set forth in paragraph
32 (a) of subdivision 18 of section 2808 of the public health law, the
33 commissioner may, subject to the availability of federal financial
34 participation, allocate 60 percent of such Medicaid rate increases
35 proportionally, based on each non-public residential health care facili-
36 ty's reported Medicaid revenue, as reported in the applicable 2005 cost
37 report as submitted to the department of health prior to November 1,
38 2006, to the total of such reported Medicaid revenue reported by all
39 such facilities, and 40 percent of such Medicaid rate increases shall be
40 allocated proportionally, based on each non-public residential health
41 care facility's reported Medicaid days of care as reported in the appli-
42 cable 2005 cost report, as submitted to the department of health prior
43 to November 1, 2006, to the total of such Medicaid days of care reported
44 by all such facilities.
45 § 44. Paragraphs (a), (b) and (f) of subdivision 30 of section 2807-c
46 of the public health law, as amended by section 3 of part E of chapter
47 63 of the laws of 2005, subparagraph (iii) of paragraph (a) as amended
48 by section 10-h and paragraph (f) as added by section 10-j of part D of
49 chapter 57 of the laws of 2006, are amended to read as follows:
50 (a) (i) The commissioner shall adjust inpatient medical assistance
51 rates of payment established pursuant to this section for non-public
52 general hospitals in accordance with subparagraph (ii) of this paragraph
53 [and shall establish discrete rates of payment for such hospitals in
54 accordance with subparagraph (iii) of this paragraph,] for purposes of
55 recruitment and retention of health care workers in the following aggre-
56 gate amounts for the following periods:
S. 2108--C 72 A. 4308--C
1 (A) ninety-three million two hundred thousand dollars on an annualized
2 basis for the period April first, two thousand two through December
3 thirty-first, two thousand two; one hundred eighty-seven million eight
4 hundred thousand dollars on an annualized basis for the period January
5 first, two thousand three through December thirty-first, two thousand
6 three; two hundred sixty-two million one hundred thousand dollars on an
7 annualized basis for the period January first, two thousand four through
8 December thirty-first, two thousand six; [and] one hundred thirty-one
9 million one hundred thousand dollars for the period January first, two
10 thousand seven through June thirtieth, two thousand seven, and two
11 hundred forty-three million five hundred thousand dollars for the period
12 July first, two thousand seven through March thirty-first, two thousand
13 eight.
14 (ii) Such increases shall be allocated proportionally based on each
15 non-public general hospital's reported total gross salary and fringe
16 benefit costs as reported on exhibit 11 of the 1999 institutional cost
17 report submitted as of November first, two thousand one to the total of
18 such reported costs for all non-public general hospitals, provided,
19 however, that for periods on and after July first, two thousand seven,
20 fifty percent of such increases shall be allocated proportionally, based
21 on each non-public hospital's reported total gross salary and fringe
22 benefit costs, as reported on exhibit 11 of the nineteen hundred nine-
23 ty-nine institutional cost report as submitted to the department prior
24 to November first, two thousand one, to the total of such reported costs
25 for all non-public general hospitals, and fifty percent of such
26 increases shall be allocated proportionally, based on each such hospi-
27 tal's total reported medicaid inpatient discharges, as reported in the
28 two thousand four institutional cost report as submitted to the depart-
29 ment prior to November first, two thousand six, to the total of such
30 reported medicaid inpatient discharges for all non-public general hospi-
31 tals, as weighted proportionally to reflect the relative medicaid case
32 mix of each such hospital. These amounts shall be included as a reim-
33 bursable cost add-on to medical assistance inpatient rates of payment
34 established pursuant to this section for non-public general hospitals
35 based on medical assistance utilization data in each hospital's annual
36 cost report submitted two years prior to the rate year. Such amounts
37 shall be reconciled to reflect changes in medical assistance utilization
38 between the year two years prior to the rate year and the rate year
39 based on data reported in each hospital's cost report for the respective
40 rate year. These amounts shall be included as a reimbursable cost add-
41 on to medical assistance inpatient rates of payment established pursuant
42 to this section for non-public general hospitals based on medical
43 assistance utilization data in each facility's annual cost report
44 submitted two years prior to the rate year. For rate adjustments effec-
45 tive May first, two thousand five and thereafter such amounts shall be
46 reconciled to reflect changes in medical assistance utilization between
47 the year two years prior to the rate year and the rate year based upon
48 data reported in each hospital's institutional cost report for the
49 respective rate year.
50 [(iii) The commissioner shall establish, subject to the approval of
51 the director of the budget, discrete rates of payment for non-public
52 general hospitals for payments under the medical assistance program
53 pursuant to titles eleven and eleven-D of article five of the social
54 services law for persons eligible for medical assistance and family
55 health plus who are enrolled in health maintenance organizations based
56 upon the calculation set forth in subparagraph (ii) of this paragraph
S. 2108--C 73 A. 4308--C
1 for such non-public general hospitals. If discrete rates of payment
2 under this subparagraph are not established, the commissioner shall
3 adjust the calculation established pursuant to subparagraph (ii) of this
4 paragraph to account for medical assistance utilization described under
5 this subparagraph for such non-public general hospital.]
6 (b) (i) Notwithstanding sections one hundred twelve and one hundred
7 sixty-three of the state finance law and any other inconsistent
8 provision of law, the commissioner shall make grants to public general
9 hospitals without a competitive bid or request for proposal process for
10 purposes of recruitment and retention of health care workers in the
11 following aggregate amounts for the following periods:
12 (A) eighteen million five hundred thousand dollars on an annualized
13 basis for the period April first, two thousand two through December
14 thirty-first, two thousand two; thirty-seven million four hundred thou-
15 sand dollars on an annualized basis for the period January first, two
16 thousand three through December thirty-first, two thousand three;
17 fifty-two million two hundred thousand dollars on an annualized basis
18 for the period January first, two thousand four through December thir-
19 ty-first, two thousand six; [and] twenty-six million one hundred thou-
20 sand dollars for the period January first, two thousand seven through
21 June thirtieth, two thousand seven, and forty-nine million dollars for
22 the period July first, two thousand seven through March thirty-first,
23 two thousand eight.
24 (ii) Such grants shall be allocated proportionally based on each
25 public general hospital's reported total gross salary and fringe benefit
26 costs as reported on exhibit 11 of the 1999 institutional cost report
27 submitted as of November first, two thousand one to the total of such
28 reported costs for all public general hospitals.
29 (f) In the event that a hospital entitled to an adjustment pursuant to
30 paragraph (a) or (e) of this subdivision closes or otherwise experiences
31 a change in status that eliminates its ability to continue to receive
32 such adjustments, the commissioner shall allocate the amount determined
33 under subparagraph (ii) of paragraph (a) and subparagraph (ii) of para-
34 graph (e) of this subdivision for such hospital to hospitals in the
35 immediate region of the closing hospital based upon the remaining hospi-
36 tals' reported gross salary and fringe benefit costs as reported on
37 exhibit eleven of the two thousand four institutional cost report
38 submitted as of November first, two thousand five to the total of such
39 reported costs for all general hospitals in the region, provided, howev-
40 er, that for periods on and after July first, two thousand seven, such
41 allocations shall be based on such remaining hospitals' reported medi-
42 caid inpatient discharges, as reported in the two thousand four institu-
43 tional cost report submitted to the department prior to November first,
44 two thousand six, to the total of such reported medicaid inpatient
45 discharges for all such remaining hospitals. The commissioner shall
46 define the immediate region as the county or counties within which work-
47 ers displaced from the closing hospital are likely to seek re-employ-
48 ment.
49 § 44-a. Notwithstanding paragraph (a) of subdivision 30 of section
50 2807-c of the public health law or any other contrary provision of law,
51 in the event the commissioner of health, in consultation with the health
52 committee chairs of the senate and the assembly and with the approval of
53 the director of the budget, determines that federal financial partic-
54 ipation will not be available for Medicaid rate increases for periods on
55 and after July 1, 2007, pursuant to the distribution methodology set
56 forth in paragraph (a) of subdivision 30 of section 2807-c of the public
S. 2108--C 74 A. 4308--C
1 health law, the commissioner of health may subject to the availability
2 of federal financial participation, allocate 100 percent of such Medi-
3 caid rate increases proportionally, based on each such hospital's total
4 reported Medicaid inpatient discharges, as reported in the 2004 institu-
5 tional cost report as submitted to the department of health prior to
6 November 1, 2006, to the total of such reported Medicaid inpatient
7 discharges for all non-public general hospitals, as weighted propor-
8 tionally to reflect the relative Medicaid case mix of each such hospi-
9 tal.
10 § 45. Subparagraphs (v) and (vi) of paragraph (a) and paragraph (b) of
11 subdivision 17 of section 2807 of the public health law, subparagraphs
12 (v) and (vi) of paragraph (a) as added by section 13 of part B of chap-
13 ter 58 of the laws of 2005 and paragraph (b) as added by section 7-a of
14 part A of chapter 1 of the laws of 2002, are amended and a new subpara-
15 graph (vii) is added to paragraph (a) to read as follows:
16 (v) for the period January first, two thousand six through December
17 thirty-first, two thousand six, thirteen million dollars; [and]
18 (vi) for the period January first, two thousand seven through June
19 thirtieth, two thousand seven, six million five hundred thousand
20 dollars; and
21 (vii) for the period July first, two thousand seven through March
22 thirty-first, two thousand eight, nine million seven hundred fifty thou-
23 sand dollars.
24 (b) Such adjustments to rates of payments shall be allocated propor-
25 tionally based on each diagnostic and treatment center's total annual
26 gross salary and fringe benefit costs, as reported in each such diagnos-
27 tic and treatment center's nineteen hundred ninety-nine cost report as
28 submitted to the department prior to November first, two thousand one,
29 provided, however, that for periods on and after July first, two thou-
30 sand seven, such adjustments to rates of payment shall be allocated
31 proportionally, based on each such diagnostic and treatment center's
32 total reported medicaid visits, as reported in each such diagnostic and
33 treatment center's two thousand four cost report as submitted to the
34 department prior to January thirty-first, two thousand seven, to the
35 total of such medicaid visits for all diagnostic and treatment centers.
36 § 46. Paragraphs (e) and (f) of subdivision 1 of section 367-q of the
37 social services law, paragraph (e) as amended by section 46-a of part C
38 of chapter 109 of the laws of 2006 and paragraph (f) as added by section
39 12 of part B of chapter 58 of the laws of 2005, are amended and a new
40 paragraph (g) is added to read as follows:
41 (e) for the period January first, two thousand six through December
42 thirty-first, two thousand six, thirty-one million dollars, provided
43 however that for the period August first, two thousand six through
44 December thirty-first, two thousand six, such rate adjustments shall be
45 increased by an additional aggregate amount of four million dollars;
46 [and]
47 (f) for the period January first, two thousand seven through June
48 thirtieth, two thousand seven, thirteen million five hundred thousand
49 dollars[.]; and
50 (g) for the period July first, two thousand seven through March thir-
51 ty-first, two thousand eight, twenty-six million two hundred fifty thou-
52 sand dollars.
53 § 47. Subdivision 2 of section 367-q of the social services law, as
54 amended by section 61 of part J of chapter 82 of the laws of 2002, is
55 amended to read as follows:
S. 2108--C 75 A. 4308--C
1 2. Such adjustments to rates of payments shall be allocated propor-
2 tionally based on each personal care services providers' total annual
3 hours of personal care services provided, as reported in each such
4 provider's nineteen hundred ninety-nine cost report as submitted to the
5 department of health prior to November first, two thousand one,
6 provided, however, that for periods on and after July first, two thou-
7 sand seven, such payments shall be in the form of a percentage add-on to
8 rates of payments of eligible providers based on the proportion of each
9 personal care services providers' total annual hours of personal care
10 services provided to recipients of medical assistance to the total annu-
11 al hours of personal care services provided by such providers.
12 § 48. Subdivision 9 of section 3614 of the public health law is
13 amended by adding a new paragraph (c) to read as follows:
14 (c) for the period July first, two thousand seven through March thir-
15 ty-first, two thousand eight, up to one hundred million dollars.
16 § 49. Paragraph (a) of subdivision 1 of section 18 of chapter 266 of
17 the laws of 1986, amending the civil practice law and rules and other
18 laws relating to malpractice and professional medical conduct, as
19 amended by section 75 of part B of chapter 58 of the laws of 2005, is
20 amended to read as follows:
21 (a) The superintendent of insurance and the commissioner of health or
22 their designee shall, from funds available in the hospital excess
23 liability pool created pursuant to subdivision (5) of this section,
24 purchase a policy or policies for excess insurance coverage, as author-
25 ized by paragraph (1) of subsection (e) of section 5502 of the insurance
26 law; or from an insurer, other than an insurer described in section 5502
27 of the insurance law, duly authorized to write such coverage and actual-
28 ly writing medical malpractice insurance in this state; or shall
29 purchase equivalent excess coverage in a form previously approved by the
30 superintendent of insurance for purposes of providing equivalent excess
31 coverage in accordance with section 19 of chapter 294 of the laws of
32 1985, for medical or dental malpractice occurrences between July 1, 1986
33 and June 30, 1987, between July 1, 1987 and June 30, 1988, between July
34 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
35 between July 1, 1990 and June 30, 1991, between July 1, 1991 and June
36 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993
37 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July
38 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997,
39 between July 1, 1997 and June 30, 1998, between July 1, 1998 and June
40 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000
41 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July
42 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004,
43 between July 1, 2004 and June 30, 2005, between July 1, 2005 and June
44 30, 2006 and between July 1, 2006 and June 30, 2007, and between July 1,
45 2007 and June 30, 2008 or reimburse the hospital where the hospital
46 purchases equivalent excess coverage as defined in subparagraph (i) of
47 paragraph (a) of subdivision (1-a) of this section for medical or dental
48 malpractice occurrences between July 1, 1987 and June 30, 1988, between
49 July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
50 between July 1, 1990 and June 30, 1991, between July 1, 1991 and June
51 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993
52 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July
53 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997,
54 between July 1, 1997 and June 30, 1998, between July 1, 1998 and June
55 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000
56 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July
S. 2108--C 76 A. 4308--C
1 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004,
2 between July 1, 2004 and June 30, 2005, between July 1, 2005 and June
3 30, 2006 and between July 1, 2006 and June 30, 2007, and between July 1,
4 2007 and June 30, 2008 for physicians or dentists certified as eligible
5 for each such period or periods pursuant to subdivision (2) of this
6 section by a general hospital licensed pursuant to article 28 of the
7 public health law; provided that no single insurer shall write more than
8 fifty percent of the total excess premium for a given policy year; and
9 provided, however, that such eligible physicians or dentists must have
10 in force an individual policy, from an insurer licensed in this state of
11 primary malpractice insurance coverage in amounts of no less than one
12 million three hundred thousand dollars for each claimant and three
13 million nine hundred thousand dollars for all claimants under that poli-
14 cy during the period of such excess coverage for such occurrences or be
15 endorsed as additional insureds under a hospital professional liability
16 policy which is offered through a voluntary attending physician ("chan-
17 neling") program previously permitted by the superintendent of insurance
18 during the period of such excess coverage for such occurrences. During
19 such period, such policy for excess coverage or such equivalent excess
20 coverage shall, when combined with the physician's or dentist's primary
21 malpractice insurance coverage or coverage provided through a voluntary
22 attending physician ("channeling") program, total an aggregate level of
23 two million three hundred thousand dollars for each claimant and six
24 million nine hundred thousand dollars for all claimants from all such
25 policies with respect to occurrences in each of such years provided,
26 however, if the cost of primary malpractice insurance coverage in excess
27 of one million dollars, but below the excess medical malpractice insur-
28 ance coverage provided pursuant to this act, exceeds the rate of nine
29 percent per annum, then the required level of primary malpractice insur-
30 ance coverage in excess of one million dollars for each claimant shall
31 be in an amount of not less than the dollar amount of such coverage
32 available at nine percent per annum; the required level of such coverage
33 for all claimants under that policy shall be in an amount not less than
34 three times the dollar amount of coverage for each claimant; and excess
35 coverage, when combined with such primary malpractice insurance cover-
36 age, shall increase the aggregate level for each claimant by one million
37 dollars and three million dollars for all claimants; and provided
38 further, that, with respect to policies of primary medical malpractice
39 coverage that include occurrences between April 1, 2002 and June 30,
40 2002, such requirement that coverage be in amounts no less than one
41 million three hundred thousand dollars for each claimant and three
42 million nine hundred thousand dollars for all claimants for such occur-
43 rences shall be effective April 1, 2002.
44 § 50. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
45 amending the civil practice law and rules and other laws relating to
46 malpractice and professional medical conduct, as amended by section 76
47 of part B of chapter 58 of the laws of 2005, is amended to read as
48 follows:
49 (3)(a) The superintendent of insurance shall determine and certify to
50 each general hospital and to the commissioner of health the cost of
51 excess malpractice insurance for medical or dental malpractice occur-
52 rences between July 1, 1986 and June 30, 1987, between July 1, 1988 and
53 June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1,
54 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between
55 July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994,
56 between July 1, 1994 and June 30, 1995, between July 1, 1995 and June
S. 2108--C 77 A. 4308--C
1 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997
2 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July
3 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001,
4 between July 1, 2001 and June 30, 2002, between July 1, 2002 and June
5 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004
6 and June 30, 2005, between July 1, 2005 and June 30, 2006 and between
7 July 1, 2006 and June 30, 2007, and between July 1, 2007 and June 30,
8 2008 allocable to each general hospital for physicians or dentists
9 certified as eligible for purchase of a policy for excess insurance
10 coverage by such general hospital in accordance with subdivision (2) of
11 this section, and may amend such determination and certification as
12 necessary.
13 (b) The superintendent of insurance shall determine and certify to
14 each general hospital and to the commissioner of health the cost of
15 excess malpractice insurance or equivalent excess coverage for medical
16 or dental malpractice occurrences between July 1, 1987 and June 30,
17 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and
18 June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1,
19 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between
20 July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
21 between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
22 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
23 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
24 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
25 between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
26 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
27 and June 30, 2006 and between July 1, 2006 and June 30, 2007, and
28 between July 1, 2007 and June 30, 2008 allocable to each general hospi-
29 tal for physicians or dentists certified as eligible for purchase of a
30 policy for excess insurance coverage or equivalent excess coverage by
31 such general hospital in accordance with subdivision (2) of this
32 section, and may amend such determination and certification as neces-
33 sary. The superintendent of insurance shall determine and certify to
34 each general hospital and to the commissioner of health the ratable
35 share of such cost allocable to the period July 1, 1987 to December 31,
36 1987, to the period January 1, 1988 to June 30, 1988, to the period July
37 1, 1988 to December 31, 1988, to the period January 1, 1989 to June 30,
38 1989, to the period July 1, 1989 to December 31, 1989, to the period
39 January 1, 1990 to June 30, 1990, to the period July 1, 1990 to December
40 31, 1990, to the period January 1, 1991 to June 30, 1991, to the period
41 July 1, 1991 to December 31, 1991, to the period January 1, 1992 to June
42 30, 1992, to the period July 1, 1992 to December 31, 1992, to the period
43 January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December
44 31, 1993, to the period January 1, 1994 to June 30, 1994, to the period
45 July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June
46 30, 1995, to the period July 1, 1995 to December 31, 1995, to the period
47 January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December
48 31, 1996, to the period January 1, 1997 to June 30, 1997, to the period
49 July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June
50 30, 1998, to the period July 1, 1998 to December 31, 1998, to the period
51 January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December
52 31, 1999, to the period January 1, 2000 to June 30, 2000, to the period
53 July 1, 2000 to December 31, 2000, to the period January 1, 2001 to June
54 30, 2001, to the period July 1, 2001 to June 30, 2002, to the period
55 July 1, 2002 to June 30, 2003, to the period July 1, 2003 to June 30,
56 2004, to the period July 1, 2004 to June 30, 2005, to the period July 1,
S. 2108--C 78 A. 4308--C
1 2005 and June 30, 2006 and to the period July 1, 2006 and June 30, 2007
2 and between July 1, 2007 and June 30, 2008.
3 § 51. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of
4 section 18 of chapter 266 of the laws of 1986, amending the civil prac-
5 tice law and rules and other laws relating to malpractice and profes-
6 sional medical conduct, as amended by section 77 of part B of chapter 58
7 of the laws of 2005, are amended to read as follows:
8 (a) To the extent funds available to the hospital excess liability
9 pool pursuant to subdivision (5) of this section as amended, and pursu-
10 ant to section 6 of part J of chapter 63 of the laws of 2001, as may
11 from time to time be amended, which amended this subdivision, are insuf-
12 ficient to meet the costs of excess insurance coverage or equivalent
13 excess coverage for coverage periods during the period July 1, 1992 to
14 June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
15 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
16 to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
17 during the period July 1, 1997 to June 30, 1998, during the period July
18 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
19 2000, during the period July 1, 2000 to June 30, 2001, during the period
20 July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
21 June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
22 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
23 to June 30, 2005, during the period July 1, 2005 to June 30, 2006 and
24 during the period July 1, 2006 to June 30, 2007, and during the period
25 July 1, 2007 to June 30, 2008 allocated or reallocated in accordance
26 with paragraph (a) of subdivision (4-a) of this section to rates of
27 payment applicable to state governmental agencies, each physician or
28 dentist for whom a policy for excess insurance coverage or equivalent
29 excess coverage is purchased for such period shall be responsible for
30 payment to the provider of excess insurance coverage or equivalent
31 excess coverage of an allocable share of such insufficiency, based on
32 the ratio of the total cost of such coverage for such physician to the
33 sum of the total cost of such coverage for all physicians applied to
34 such insufficiency.
35 (b) Each provider of excess insurance coverage or equivalent excess
36 coverage covering the period July 1, 1992 to June 30, 1993, or covering
37 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
38 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
39 1996, or covering the period July 1, 1996 to June 30, 1997, or covering
40 the period July 1, 1997 to June 30, 1998, or covering the period July 1,
41 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
42 2000, or covering the period July 1, 2000 to June 30, 2001, or covering
43 the period July 1, 2001 to October 29, 2001, or covering the period
44 April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
45 June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
46 covering the period July 1, 2004 to June 30, 2005, or covering the peri-
47 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
48 June 30, 2007, or covering the period July 1, 2007 to June 30, 2008
49 shall notify a covered physician or dentist by mail, mailed to the
50 address shown on the last application for excess insurance coverage or
51 equivalent excess coverage, of the amount due to such provider from such
52 physician or dentist for such coverage period determined in accordance
53 with paragraph (a) of this subdivision. Such amount shall be due from
54 such physician or dentist to such provider of excess insurance coverage
55 or equivalent excess coverage in a time and manner determined by the
56 superintendent of insurance.
S. 2108--C 79 A. 4308--C
1 (c) If a physician or dentist liable for payment of a portion of the
2 costs of excess insurance coverage or equivalent excess coverage cover-
3 ing the period July 1, 1992 to June 30, 1993, or covering the period
4 July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
5 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
6 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
7 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
8 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
9 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
10 od July 1, 2001 to October 29, 2001, or covering the period April 1,
11 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
12 2003, or covering the period July 1, 2003 to June 30, 2004, or covering
13 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
14 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
15 2007, or covering the period July 1, 2007 to June 30, 2008 determined in
16 accordance with paragraph (a) of this subdivision fails, refuses or
17 neglects to make payment to the provider of excess insurance coverage or
18 equivalent excess coverage in such time and manner as determined by the
19 superintendent of insurance pursuant to paragraph (b) of this subdivi-
20 sion, excess insurance coverage or equivalent excess coverage purchased
21 for such physician or dentist in accordance with this section for such
22 coverage period shall be cancelled and shall be null and void as of the
23 first day on or after the commencement of a policy period where the
24 liability for payment pursuant to this subdivision has not been met.
25 (d) Each provider of excess insurance coverage or equivalent excess
26 coverage shall notify the superintendent of insurance and the commis-
27 sioner of health or their designee of each physician and dentist eligi-
28 ble for purchase of a policy for excess insurance coverage or equivalent
29 excess coverage covering the period July 1, 1992 to June 30, 1993, or
30 covering the period July 1, 1993 to June 30, 1994, or covering the peri-
31 od July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to
32 June 30, 1996, or covering the period July 1, 1996 to June 30, 1997, or
33 covering the period July 1, 1997 to June 30, 1998, or covering the peri-
34 od July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to
35 June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or
36 covering the period July 1, 2001 to October 29, 2001, or covering the
37 period April 1, 2002 to June 30, 2002, or covering the period July 1,
38 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30,
39 2004, or covering the period July 1, 2004 to June 30, 2005, or covering
40 the period July 1, 2005 to June 30, 2006, or covering the period July 1,
41 2006 to June 30, 2007, or covering the period July 1, 2007 to June 30,
42 2008 that has made payment to such provider of excess insurance coverage
43 or equivalent excess coverage in accordance with paragraph (b) of this
44 subdivision and of each physician and dentist who has failed, refused or
45 neglected to make such payment.
46 (e) A provider of excess insurance coverage or equivalent excess
47 coverage shall refund to the hospital excess liability pool any amount
48 allocable to the period July 1, 1992 to June 30, 1993, and to the period
49 July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
50 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
51 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
52 June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
53 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
54 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
55 and to the period April 1, 2002 to June 30, 2002, and to the period July
56 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
S. 2108--C 80 A. 4308--C
1 2004, and to the period July 1, 2004 to June 30, 2005, and to the period
2 July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
3 30, 2007, and to the period July 1, 2007 to June 30, 2008 received from
4 the hospital excess liability pool for purchase of excess insurance
5 coverage or equivalent excess coverage covering the period July 1, 1992
6 to June 30, 1993, and covering the period July 1, 1993 to June 30, 1994,
7 and covering the period July 1, 1994 to June 30, 1995, and covering the
8 period July 1, 1995 to June 30, 1996, and covering the period July 1,
9 1996 to June 30, 1997, and covering the period July 1, 1997 to June 30,
10 1998, and covering the period July 1, 1998 to June 30, 1999, and cover-
11 ing the period July 1, 1999 to June 30, 2000, and covering the period
12 July 1, 2000 to June 30, 2001, and covering the period July 1, 2001 to
13 October 29, 2001, and covering the period April 1, 2002 to June 30,
14 2002, and covering the period July 1, 2002 to June 30, 2003, and cover-
15 ing the period July 1, 2003 to June 30, 2004, and covering the period
16 July 1, 2004 to June 30, 2005, and covering the period July 1, 2005 to
17 June 30, 2006, and covering the period July 1, 2006 to June 30, 2007,
18 and covering the period July 1, 2007 to June 30, 2008 for a physician or
19 dentist where such excess insurance coverage or equivalent excess cover-
20 age is cancelled in accordance with paragraph (c) of this subdivision.
21 § 52. Section 40 of chapter 266 of the laws of 1986, amending the
22 civil practice law and rules and other laws relating to malpractice and
23 professional medical conduct, as amended by section 78 of part B of
24 chapter 58 of the laws of 2005, is amended to read as follows:
25 § 40. The superintendent of insurance shall establish rates for poli-
26 cies providing coverage for physicians and surgeons medical malpractice
27 for the periods commencing July 1, 1985 and ending June 30, [2007] 2008.
28 The superintendent shall direct insurers to establish segregated
29 accounts for premiums, payments, reserves and investment income attrib-
30 utable to such premium periods and shall require periodic reports by the
31 insurers regarding claims and expenses attributable to such periods to
32 monitor whether such accounts will be sufficient to meet incurred claims
33 and expenses. On or after July 1, 1989, the superintendent shall impose
34 a surcharge on premiums to satisfy a projected deficiency that is
35 attributable to the premium levels established pursuant to this section
36 for such periods; provided, however, that such annual surcharge shall
37 not exceed eight percent of the established rate until July 1, [2007]
38 2008, at which time and thereafter such surcharge shall not exceed twen-
39 ty-five percent of the approved adequate rate, and that such annual
40 surcharges shall continue for such period of time as shall be sufficient
41 to satisfy such deficiency. On and after July 1, 1989, the surcharge
42 prescribed by this section shall be retained by insurers to the extent
43 that they insured physicians and surgeons during the July 1, 1985
44 through June 30, [2007] 2008 policy periods; in the event and to the
45 extent physicians and surgeons were insured by another insurer during
46 such periods, all or a pro rata share of the surcharge, as the case may
47 be, shall be remitted to such other insurer in accordance with rules and
48 regulations to be promulgated by the superintendent. Surcharges
49 collected from physicians and surgeons who were not insured during such
50 policy periods shall be apportioned among all insurers in proportion to
51 the premium written by each insurer during such policy periods; if a
52 physician or surgeon was insured by an insurer subject to rates estab-
53 lished by the superintendent during such policy periods, and at any time
54 thereafter a hospital, health maintenance organization, employer or
55 institution is responsible for responding in damages for liability aris-
56 ing out of such physician's or surgeon's practice of medicine, such
S. 2108--C 81 A. 4308--C
1 responsible entity shall also remit to such prior insurer the equivalent
2 amount that would then be collected as a surcharge if the physician or
3 surgeon had continued to remain insured by such prior insurer. In the
4 event any insurer that provided coverage during such policy periods is
5 in liquidation, the property/casualty insurance security fund shall
6 receive the portion of surcharges to which the insurer in liquidation
7 would have been entitled. The surcharges authorized herein shall be
8 deemed to be income earned for the purposes of section 2303 of the
9 insurance law. The superintendent, in establishing adequate rates and
10 in determining any projected deficiency pursuant to the requirements of
11 this section and the insurance law, shall give substantial weight,
12 determined in his discretion and judgment, to the prospective antic-
13 ipated effect of any regulations promulgated and laws enacted and the
14 public benefit of stabilizing malpractice rates and minimizing rate
15 level fluctuation during the period of time necessary for the develop-
16 ment of more reliable statistical experience as to the efficacy of such
17 laws and regulations affecting medical, dental or podiatric malpractice
18 enacted or promulgated in 1985, 1986, by this act and at any other time.
19 Notwithstanding any provision of the insurance law, rates already estab-
20 lished and to be established by the superintendent pursuant to this
21 section are deemed adequate if such rates would be adequate when taken
22 together with the maximum authorized annual surcharges to be imposed for
23 a reasonable period of time whether or not any such annual surcharge has
24 been actually imposed as of the establishment of such rates.
25 § 53. Subsection (c) of section 2343 of the insurance law, as amended
26 by section 79 of part B of chapter 58 of the laws of 2005, is amended to
27 read as follows:
28 (c) Notwithstanding any other provision of this chapter, no applica-
29 tion for an order of rehabilitation or liquidation of a domestic insurer
30 whose primary liability arises from the business of medical malpractice
31 insurance, as that term is defined in subsection (b) of section five
32 thousand five hundred one of this chapter, shall be made on the grounds
33 specified in subsection (a) or (c) of section seven thousand four
34 hundred two of this chapter at any time prior to June thirtieth, two
35 thousand [seven] eight.
36 § 54. Section 5 and subdivisions (a) and (e) of section 6 of part J of
37 chapter 63 of the laws of 2001, amending chapter 20 of the laws of 2001
38 amending the military law and other laws relating to making appropri-
39 ations for the support of government, as amended by section 80 of part B
40 of chapter 58 of the laws of 2005, are amended to read as follows:
41 § 5. The superintendent of insurance and the commissioner of health
42 shall determine, no later than June 15, 2002, June 15, 2003, June 15,
43 2004, June 15, 2005, June 15, 2006 [and], June 15, 2007 and June 15,
44 2008, the amount of funds available in the hospital excess liability
45 pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
46 and whether such funds are sufficient for purposes of purchasing excess
47 insurance coverage for eligible participating physicians and dentists
48 during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
49 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
50 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
51 2007, or July 1, 2007 to June 30, 2008, as applicable.
52 (a) This section shall be effective only upon a determination, pursu-
53 ant to section five of this act, by the superintendent of insurance and
54 the commissioner of health, and a certification of such determination to
55 the state director of the budget, the chair of the senate committee on
56 finance and the chair of the assembly committee on ways and means, that
S. 2108--C 82 A. 4308--C
1 the amount of funds in the hospital excess liability pool, created
2 pursuant to section 18 of chapter 266 of the laws of 1986, is insuffi-
3 cient for purposes of purchasing excess insurance coverage for eligible
4 participating physicians and dentists during the period July 1, 2001 to
5 June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June
6 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30,
7 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June 30,
8 2008, as applicable.
9 (e) The commissioner of health shall transfer for deposit to the
10 hospital excess liability pool created pursuant to section 18 of chapter
11 266 of the laws of 1986 such amounts as directed by the superintendent
12 of insurance for the purchase of excess liability insurance coverage for
13 eligible participating physicians and dentists for the policy year July
14 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1,
15 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005
16 to June 30, 2006, or July 1, 2006 to June 30, 2007, as applicable, and
17 the cost of administering the hospital excess liability pool for such
18 applicable policy year, pursuant to the program established in chapter
19 266 of the laws of 1986, as amended, no later than June 15, 2002, June
20 15, 2003, June 15, 2004, June 15, 2005, June 15, 2006, [and] June 15,
21 2007, and June 15, 2008, as applicable.
22 § 55. Section 2807-p of the public health law, as amended by section
23 17 of part A3 of chapter 62 of the laws of 2003, subdivision 1 as
24 amended by section 15 of part H of chapter 686 of the laws of 2003,
25 paragraph (a) of subdivision 2 as amended by chapter 80 of the laws of
26 2004, paragraph (a) of subdivision 4 as amended by section 91, clause
27 (C) of subparagraph (i) of paragraph (a) of subdivision 4-a as amended
28 and clauses (D) and (E) of subparagraph (i) of paragraph (a) of subdivi-
29 sion 4-a as added by section 92, clause (C) of subparagraph (i) of para-
30 graph (b) of subdivision 4-a as amended and clauses (D) and (E) of
31 subparagraph (i) of paragraph (b) of subdivision 4-a as added by section
32 93, clause (C) of subparagraph (i) of paragraph (c) of subdivision 4-a
33 as amended and clauses (D) and (E) of subparagraph (i) of paragraph (c)
34 of subdivision 4-a as added by section 94, subparagraph (iii) of para-
35 graph (d) of subdivision 4-a as amended and subparagraph (iv) of para-
36 graph (d) of subdivision 4-a as added by section 95, subparagraph (iii)
37 of paragraph (e) of subdivision 4-a as amended and subparagraph (iv) of
38 paragraph (e) of subdivision 4-a as added by section 96, and subpara-
39 graph (iii) of paragraph (a) of subdivision 4-b as amended and subpara-
40 graph (iv) of paragraph (a) of subdivision 4-b as added by section 97 of
41 part B of chapter 58 of the laws of 2005, subdivision 4-c as added by
42 section 15-a of part C of chapter 109 of the laws of 2006, and subdivi-
43 sion 9 as amended by section 53 of part B of chapter 58 of the laws of
44 2004, is amended to read as follows:
45 § 2807-p. Comprehensive diagnostic and treatment centers indigent care
46 program. 1. (a) For periods prior to July first, two thousand three,
47 [and in the event federal financial participation is not available for
48 rate adjustments pursuant to this section, on and after July first, two
49 thousand three,] and on and after July first, two thousand five the
50 commissioner is authorized to make payments to eligible diagnostic and
51 treatment centers, to the extent of funds available therefor, up to
52 forty-eight million dollars annually, to assist in meeting losses
53 resulting from uncompensated care. The amount of funds available for
54 such payments pursuant to subdivision four of this section shall be the
55 amount remaining after the allocation provided in section seven of chap-
56 ter four hundred thirty-three of the laws of nineteen hundred ninety-
S. 2108--C 83 A. 4308--C
1 seven as amended by section seventy-five of chapter one of the laws of
2 nineteen hundred ninety-nine.
3 (b) For periods on and after July first, two thousand three, through
4 June thirtieth, two thousand five, the commissioner shall, subject to
5 the availability of federal financial participation, adjust medical
6 assistance rates of payment to assist in meeting losses resulting from
7 uncompensated care, provided, however, in the event federal financial
8 participation is not available, the commissioner is authorized to
9 continue to make payments to eligible diagnostic and treatment centers,
10 to the extent of funds available therefor, in accordance with provisions
11 of paragraph (a) of this subdivision and without regard to the
12 provisions of subdivisions four-a and four-b of this section.
13 2. Definitions. (a) "Eligible diagnostic and treatment centers", for
14 purposes of this section, shall mean voluntary non-profit and publicly
15 sponsored diagnostic and treatment centers providing a comprehensive
16 range of primary health care services which can demonstrate losses from
17 disproportionate share of uncompensated care during a base period two
18 years prior to the grant period; provided that for periods on and after
19 January first, two thousand four an eligible diagnostic and treatment
20 center shall not include [(i) any qualified hospital-controlled diagnos-
21 tic and treatment center as defined in section twenty-eight hundred
22 seven-k of this article, or (ii)] any voluntary non-profit diagnostic
23 and treatment center controlling, controlled by or under common control
24 with a health maintenance organization, as defined by subdivision one of
25 section forty-four hundred one of this chapter; provided further that
26 for purposes of this section, a health maintenance organization shall
27 not include a prepaid health services plan licensed pursuant to section
28 forty-four hundred three-a of this chapter. For periods on and after
29 July first, two thousand three, the base period and the grant period
30 shall be the calendar year.
31 (b) "Uncompensated care need", for purposes of this section, means
32 losses from reported self-pay and free visits multiplied by the facili-
33 ty's medical assistance payment rate for the applicable distribution
34 year, offset by payments received from such patients during the report-
35 ing period.
36 3. (a) During the period January first, nineteen hundred ninety-seven
37 through September thirtieth, nineteen hundred ninety-seven and for each
38 fiscal year period commencing on October first thereafter through Decem-
39 ber thirty-first, nineteen hundred ninety-nine and for periods on and
40 after January first, two thousand, diagnostic and treatment centers
41 shall be eligible for allocations of funds or for rate adjustments
42 determined in accordance with this section to reflect the needs of the
43 diagnostic and treatment center for the financing of losses resulting
44 from uncompensated care.
45 (b) A diagnostic and treatment center qualifying for a distribution or
46 a rate adjustment pursuant to this section shall provide assurances
47 satisfactory to the commissioner that it shall undertake reasonable
48 efforts to maintain financial support from community and public funding
49 sources and reasonable efforts to collect payments for services from
50 third-party insurance payors, governmental payors and self-paying
51 patients.
52 (c) To be eligible for an allocation of funds or a rate adjustment
53 pursuant to this section, a diagnostic and treatment center must provide
54 a comprehensive range of primary health care services and must demon-
55 strate that a minimum of five percent of total clinic visits reported
56 during the applicable base year period were to uninsured individuals.
S. 2108--C 84 A. 4308--C
1 The commissioner may retrospectively reduce the allocations of funds or
2 the rate adjustments to a diagnostic and treatment center if it is
3 determined that provider management actions or decisions have caused a
4 significant reduction for the grant period in the delivery of comprehen-
5 sive primary health care services to uncompensated care residents of the
6 community.
7 4. (a) (i) The total amount of funds to be allocated and distributed
8 for uncompensated care to eligible voluntary non-profit diagnostic and
9 treatment centers for a distribution period prior to July first, two
10 thousand three, and on and after July first, two thousand [three in the
11 event that federal financial participation is not available for rate
12 adjustments pursuant to this section] five through December thirty-
13 first, two thousand six, in accordance with this subdivision shall be
14 limited to thirty-three percent of the funds available therefor pursuant
15 to paragraph (a) of subdivision one of this section and, for the period
16 January first, two thousand seven through December thirty-first, two
17 thousand seven, such distributions shall be limited to sixteen and one-
18 half percent of the funds available therefor.
19 (ii) The total amount of funds to be allocated and distributed for
20 uncompensated care to eligible publicly sponsored diagnostic and treat-
21 ment centers for a grant period prior to July first, two thousand three,
22 and on and after July first, two thousand [three in the event that
23 federal financial participation is not available for rate adjustments
24 pursuant to this section] five through December thirty-first, two thou-
25 sand six, in accordance with this subdivision shall be limited to
26 sixty-seven percent of funds available therefor pursuant to paragraph
27 (a) of subdivision one of this section and, for the period January
28 first, two thousand seven through December thirty-first, two thousand
29 seven, such distributions shall be limited to thirty-three and one-half
30 percent of the funds available therefor; provided, however, that for
31 periods up through December thirty-first, two thousand seven, forty-one
32 percent of the amount of funds allocated for distribution to eligible
33 publicly sponsored diagnostic and treatment centers shall be available
34 for clinics operating under the auspices of the New York city health and
35 hospitals corporation as established by chapter one thousand sixteen of
36 the laws of nineteen hundred sixty-nine as amended.
37 [(iii) (A) Notwithstanding the provisions of subparagraph (ii) of this
38 paragraph and any other provision of this chapter, municipalities which
39 received state aid pursuant to article two of this chapter for the nine-
40 teen hundred eighty-nine--nineteen hundred ninety state fiscal year in
41 support of non-hospital based free-standing or local health department
42 operated general medical clinics shall receive an uncompensated care
43 grant allocation of funds on an annualized basis through December thir-
44 ty-first, two thousand two, of not less than the amount received in the
45 nineteen hundred eighty-nine--nineteen hundred ninety state fiscal year
46 for general medical clinics.
47 (B) For the period January first, two thousand three through June
48 thirtieth, two thousand three, each such municipality shall receive an
49 uncompensated care grant allocation of funds of not less than one-half
50 the amount calculated pursuant to clause (A) of this subparagraph.
51 (C) For the period July first, two thousand three through December
52 thirty-first, two thousand three, each such municipality shall receive
53 an uncompensated care grant allocation of funds of not less than one-
54 half the amount calculated pursuant to clause (A) of this subparagraph.
55 (D) For periods on and after January first, two thousand four through
56 December thirty-first, two thousand six, each such municipality shall
S. 2108--C 85 A. 4308--C
1 receive an uncompensated care grant allocation of funds of not less than
2 the amount calculated pursuant to clause (A) of this subparagraph.
3 (E) For the period January first, two thousand seven through June
4 thirtieth, two thousand seven, each such municipality shall receive an
5 uncompensated care grant allocation of funds of not less than one-half
6 the amount calculated pursuant to clause (A) of this subparagraph.
7 (iv)] (iii) (A) Notwithstanding any inconsistent provision of this
8 paragraph, for the period January first, nineteen hundred ninety-seven
9 through December thirty-first, nineteen hundred ninety-nine and for
10 periods on and after January first, two thousand through December thir-
11 ty-first, two thousand two, and for periods on and after January first,
12 two thousand four through December thirty-first, two thousand [six]
13 seven, in the event that federal financial participation is not avail-
14 able for rate adjustments pursuant to this section, diagnostic and
15 treatment centers which received an allowance pursuant to paragraph (f)
16 of subdivision two of section twenty-eight hundred seven of this article
17 for the period through December thirty-first, nineteen hundred ninety-
18 six shall receive an annual uncompensated care distribution allocation
19 of funds of not less than the amount that would have been received for
20 any losses associated with the delivery of bad debt and charity care for
21 nineteen hundred ninety-five had the provisions of paragraph (f) of
22 subdivision two of section twenty-eight hundred seven of this article
23 remained in effect, provided, however, that for the period January
24 first, two thousand seven through December thirty-first, two thousand
25 seven, the dollar value of the application of the provisions of this
26 subparagraph for any such diagnostic and treatment center shall be
27 reduced by fifty percent.
28 (B) For the period January first, two thousand three through June
29 thirtieth, two thousand three, and for the period July first, two thou-
30 sand three through December thirty-first, two thousand three and [Janu-
31 ary first, two thousand seven through June thirtieth, two thousand
32 seven,] in the event that federal financial participation is not avail-
33 able for rate adjustments pursuant to this section, each such diagnostic
34 and treatment center shall receive an uncompensated care distribution
35 allocation of funds of not less than one-half the amount calculated
36 pursuant to clause (A) of this subparagraph.
37 (b) (i) A nominal payment amount for the financing of losses associ-
38 ated with the delivery of uncompensated care will be established for
39 each eligible diagnostic and treatment center. The nominal payment
40 amount shall be calculated as the sum of the dollars attributable to the
41 application of an incrementally increasing nominal coverage percentage
42 of base year period losses associated with the delivery of uncompensated
43 care for percentage increases in the relationship between base year
44 period eligible uninsured care clinic visits and base year period total
45 clinic visits according to the following scale:
46 % of eligible bad debt and charity care % of nominal financial
47 clinic visits to total visits loss coverage
48 up to 15% 50%
49 15 - 30% 75%
50 30%+ 100%
51 (ii) [If] For periods prior to January first, two thousand eight, if
52 the sum of the nominal payment amounts for all eligible voluntary non-
53 profit diagnostic and treatment centers or for all eligible public diag-
54 nostic and treatment centers or for all clinics operating under the
S. 2108--C 86 A. 4308--C
1 auspices of the New York city health and hospitals corporation is less
2 than the amount allocated for uncompensated care allowances pursuant to
3 paragraph (a) of this subdivision for such diagnostic and treatment
4 centers respectively, the nominal coverage percentages of base year
5 period losses associated with the delivery of uncompensated care pursu-
6 ant to this scale may be increased to not more than one hundred percent
7 for voluntary non-profit diagnostic and treatment centers or for public
8 diagnostic and treatment centers or for all clinics operating under the
9 auspices of the New York city health and hospitals corporation in
10 accordance with rules and regulations adopted by the council and
11 approved by the commissioner.
12 (c) [The] For periods prior to January first, two thousand eight, the
13 uncompensated care allocations of funds for each eligible voluntary
14 non-profit diagnostic and treatment center, as computed in accordance
15 with paragraph (a) of this subdivision, shall be based on the dollar
16 value of the result of the ratio of total funds allocated for distrib-
17 utions for voluntary non-profit diagnostic and treatment centers pursu-
18 ant to paragraph (a) of this subdivision to the total statewide nominal
19 payment amounts for all eligible voluntary non-profit diagnostic and
20 treatment centers determined in accordance with paragraph (b) of this
21 subdivision applied to the nominal payment amount for each such diagnos-
22 tic and treatment center.
23 (d) [The] For periods prior to January first, two thousand eight, the
24 uncompensated care allocations of funds for each eligible public diag-
25 nostic and treatment center, other than clinics operating under the
26 auspices of the New York city health and hospitals corporation and as
27 computed in accordance with paragraph (a) of this subdivision, shall be
28 based on the dollar value of the result of the ratio of total funds
29 allocated for distributions for public diagnostic and treatment centers,
30 other than clinics operating under the auspices of the New York city
31 health and hospitals corporation, pursuant to paragraph (a) of this
32 subdivision to the total statewide nominal payment amounts for all
33 eligible public diagnostic and treatment centers, other than clinics
34 operating under the auspices of the New York city health and hospitals
35 corporation, determined in accordance with paragraph (b) of this subdi-
36 vision applied to the nominal payment amount for each such diagnostic
37 and treatment center.
38 (e) [The] For periods prior to January first, two thousand eight, the
39 uncompensated care grant allocations of funds for each eligible public
40 diagnostic and treatment center operating under the auspices of the New
41 York city health and hospitals corporation, as computed in accordance
42 with paragraph (a) of this subdivision, shall be based on the dollar
43 value of the result of the ratio of total funds allocated for distrib-
44 utions for public diagnostic and treatment centers operating under the
45 auspices of the New York city health and hospitals corporation pursuant
46 to paragraph (a) of this subdivision to the total statewide nominal
47 payment amounts for all eligible public diagnostic and treatment centers
48 operating under the auspices of the New York city health and hospitals
49 corporation determined in accordance with paragraph (b) of this subdivi-
50 sion applied to the nominal payment amount for each such diagnostic and
51 treatment center.
52 (f) [Any] For periods prior to January first, two thousand eight, any
53 residual amount allocated for distribution to a classification of diag-
54 nostic and treatment centers in accordance with this subdivision shall
55 be reallocated by the commissioner for distributions to the other clas-
56 sifications based on remaining need.
S. 2108--C 87 A. 4308--C
1 (g) For periods on and after January first, two thousand seven, the
2 uncompensated care allocations of funds for each eligible diagnostic and
3 treatment center, other than allocations made pursuant to paragraphs
4 (c), (d), (e) or (f) of this subdivision, shall be based on the dollar
5 value of the result of the ratio of total funds allocated for distrib-
6 utions for all eligible diagnostic and treatment centers to the total
7 statewide nominal payment amounts for all eligible diagnostic and treat-
8 ment centers determined in accordance with paragraph (b) of this subdi-
9 vision applied to the nominal payment amount for each such diagnostic
10 and treatment center.
11 4-a. (a)(i) For periods on and after July first, two thousand three,
12 through June thirtieth, two thousand five, funds shall be made available
13 for adjustments to rates of payments made pursuant to paragraph (b) of
14 subdivision one of this section for eligible voluntary non-profit diag-
15 nostic and treatment centers in accordance with subparagraphs (ii) and
16 (iii) of this paragraph, for the following periods in the following
17 aggregate amounts:
18 (A) For the period July first, two thousand three through December
19 thirty-first, two thousand three, up to seven million five hundred thou-
20 sand dollars;
21 (B) For the period January first, two thousand four through December
22 thirty-first, two thousand four, up to fifteen million dollars;
23 (C) For the period January first, two thousand five through [December
24 thirty-first] June thirtieth, two thousand five, up to [fifteen] seven
25 million five hundred thousand dollars[;].
26 [(D) For the period January first, two thousand six through December
27 thirty-first, two thousand six, up to fifteen million dollars;
28 (E) For the period January first, two thousand seven through June
29 thirtieth, two thousand seven, up to seven million five hundred thousand
30 dollars.]
31 (ii) A nominal payment amount for the financing of losses associated
32 with the delivery of uncompensated care will be established for each
33 eligible diagnostic and treatment center. The nominal payment amount
34 shall be calculated as the sum of the dollars attributable to the appli-
35 cation of an incrementally increasing nominal coverage percentage of
36 base year period losses associated with the delivery of uncompensated
37 care for percentage increases in the relationship between base year
38 period eligible uninsured care clinic visits and base year period total
39 clinic visits according to the following scale:
40 % of eligible bad debt and charity care % of nominal financial
41 clinic visits to total visits loss coverage
42 up to 15% 50%
43 15 - 30% 75%
44 30%+ 100%
45 (iii) The uncompensated care rate adjustments for each eligible volun-
46 tary non-profit diagnostic and treatment center shall be based on the
47 dollar value of the result of the ratio of total funds allocated for
48 distributions for voluntary non-profit diagnostic and treatment centers
49 pursuant to subparagraph (i) of this paragraph, to the total statewide
50 nominal payment amounts for all eligible voluntary non-profit diagnostic
51 and treatment centers determined in accordance with subparagraph (ii) of
52 this paragraph applied to the nominal payment amount for each such diag-
53 nostic and treatment center.
S. 2108--C 88 A. 4308--C
1 (b)(i) For periods on and after July first, two thousand three through
2 June thirtieth, two thousand five, funds shall be made available for
3 adjustments to rates of payments made pursuant to paragraph (b) of
4 subdivision one of this section for eligible public diagnostic and
5 treatment centers, other than clinics operated under the auspices of the
6 New York city health and hospitals corporation, in accordance with
7 subparagraphs (ii) and (iii) of this paragraph, for the following peri-
8 ods in the following aggregate amounts:
9 (A) For the period July first, two thousand three through December
10 thirty-first, two thousand three, up to nine million dollars;
11 (B) For the period January first, two thousand four through December
12 thirty-first, two thousand four, up to eighteen million dollars;
13 (C) For the period January first, two thousand five through [December
14 thirty-first] June thirtieth, two thousand five, up to [eighteen] nine
15 million dollars[;].
16 [(D) For the period January first, two thousand six through December
17 thirty-first, two thousand six, up to eighteen million dollars;
18 (E) For the period January first, two thousand seven through June
19 thirtieth, two thousand seven, up to nine million dollars.]
20 (ii) A nominal payment amount for the financing of losses associated
21 with the delivery of uncompensated care will be established for each
22 eligible diagnostic and treatment center. The nominal payment amount
23 shall be calculated as the sum of the dollars attributable to the appli-
24 cation of an incrementally increasing nominal coverage percentage of
25 base year period losses associated with the delivery of uncompensated
26 care for percentage increases in the relationship between base year
27 period eligible uninsured care clinic visits and base year period total
28 clinic visits according to the following scale:
29 % of eligible bad debt and charity care % of nominal financial
30 clinic visits to total visits loss coverage
31 up to 15% 50%
32 15 - 30% 75%
33 30%+ 100%
34 (iii) The uncompensated care rate adjustments for each eligible public
35 diagnostic and treatment center, other than clinics operating under the
36 auspices of the New York city health and hospitals corporation, shall be
37 based on the dollar value of the result of the ratio of total funds
38 allocated for distributions for public diagnostic and treatment centers,
39 other than clinics operating under the auspices of the New York city
40 health and hospitals corporation, pursuant to subparagraph (i) of this
41 paragraph to the total statewide nominal payment amounts for all eligi-
42 ble public diagnostic and treatment centers, other than clinics operat-
43 ing under the auspices of the New York city health and hospitals corpo-
44 ration, determined in accordance with subparagraph (ii) of this
45 paragraph applied to the nominal payment amount for each such diagnostic
46 and treatment center.
47 (c)(i) For periods on and after July first, two thousand three,
48 through June thirtieth, two thousand five, funds shall be made available
49 for adjustments to rates of payments made pursuant to paragraph (b) of
50 subdivision one of this section for eligible public diagnostic and
51 treatment centers operating under the auspices of the New York city
52 health and hospitals corporation, in accordance with subparagraphs (ii)
53 and (iii) of this paragraph, for the following periods in the following
54 aggregate amounts:
S. 2108--C 89 A. 4308--C
1 (A) For the period July first, two thousand three through December
2 thirty-first, two thousand three, up to six million dollars;
3 (B) For the period January first, two thousand four through December
4 thirty-first, two thousand four, up to twelve million dollars;
5 (C) For the period January first, two thousand five through [December
6 thirty-first] June thirtieth, two thousand five, up to [twelve] six
7 million dollars[;].
8 [(D) For the period January first, two thousand six through December
9 thirty-first, two thousand six, up to twelve million dollars;
10 (E) For the period January first, two thousand seven through June
11 thirtieth, two thousand seven, up to six million dollars.]
12 (ii) A nominal payment amount for the financing of losses associated
13 with the delivery of uncompensated care will be established for each
14 eligible diagnostic and treatment center. The nominal payment amount
15 shall be calculated as the sum of the dollars attributable to the appli-
16 cation of an incrementally increasing nominal coverage percentage of
17 base year period losses associated with the delivery of uncompensated
18 care for percentage increases in the relationship between base year
19 period eligible uninsured care clinic visits and base year period total
20 clinic visits according to the following scale:
21 % of eligible bad debt and charity care % of nominal financial
22 clinic visits to total visits loss coverage
23 up to 15% 50%
24 15 - 30% 75%
25 30%+ 100%
26 (iii) The uncompensated care rate adjustment, for each eligible public
27 diagnostic and treatment center operating under the auspices of the New
28 York city health and hospitals corporation shall be based on the dollar
29 value of the result of the ratio of total funds allocated for distrib-
30 utions for public diagnostic and treatment centers operating under the
31 auspices of the New York city health and hospitals corporation pursuant
32 to subparagraph (i) of this paragraph to the total statewide nominal
33 payment amounts for all eligible public diagnostic and treatment centers
34 operating under the auspices of the New York city health and hospitals
35 corporation determined in accordance with subparagraph (ii) of this
36 paragraph applied to the nominal payment amount for each such diagnostic
37 and treatment center.
38 (d) (i) Notwithstanding the provisions of paragraph (b) of this subdi-
39 vision and any other provisions of this chapter, municipalities which
40 received state aid pursuant to article two of this chapter for the nine-
41 teen hundred eighty-nine--nineteen hundred ninety state fiscal year in
42 support of non-hospital based free-standing or local health department
43 operated general medical clinics shall receive an uncompensated care
44 rate adjustment for the period July first, two thousand three through
45 December thirty-first, two thousand three, of not less than one-half the
46 amount received in the nineteen hundred eighty-nine--nineteen hundred
47 ninety state fiscal year for general medical clinics.
48 (ii) For the period January first, two thousand four through December
49 thirty-first, two thousand four, each such municipality shall receive an
50 uncompensated care rate adjustment of not less than twice the amount
51 calculated pursuant to subparagraph (i) of this paragraph.
52 (iii) For the period January first, two thousand five through [Decem-
53 ber thirty-first] June thirtieth, two thousand [six] five, each such
54 municipality shall receive an annual uncompensated care rate adjustment
S. 2108--C 90 A. 4308--C
1 of not less than [twice] the amount calculated pursuant to subparagraph
2 (i) of this paragraph[;].
3 [(iv) For the period January first, two thousand seven through June
4 thirtieth, two thousand seven, each such municipality shall receive an
5 uncompensated care rate adjustment of not less than the amount calcu-
6 lated pursuant to subparagraph (i) of this paragraph.]
7 (e) (i) Notwithstanding any inconsistent provision of this subdivi-
8 sion, for the period July first, two thousand three through December
9 thirty-first, two thousand three, diagnostic and treatment centers which
10 received an allowance pursuant to paragraph (f) of subdivision two of
11 section twenty-eight hundred seven of this article for the period
12 through December thirty-first, nineteen hundred ninety-six shall receive
13 an uncompensated care rate adjustment of not less than one-half the
14 amount that would have been received for any losses associated with the
15 delivery of bad debt and charity care for nineteen hundred ninety-five
16 had the provisions of paragraph (f) of subdivision two of section twen-
17 ty-eight hundred seven of this article remained in effect.
18 (ii) For the period January first, two thousand four through December
19 thirty-first, two thousand four, each such diagnostic and treatment
20 center shall receive an uncompensated care rate adjustment of not less
21 than twice the amount calculated pursuant to subparagraph (i) of this
22 paragraph.
23 (iii) For the period January first, two thousand five through [Decem-
24 ber thirty-first] June thirtieth, two thousand [six] five, each such
25 diagnostic and treatment center shall receive an annual uncompensated
26 care rate adjustment of not less than [twice] the amount calculated
27 pursuant to subparagraph (i) of this paragraph, and shall be subject to
28 subsequent adjustment or reconciliation[;].
29 [(iv) For the period January first, two thousand seven through June
30 thirtieth, two thousand seven, each such diagnostic and treatment center
31 shall receive an uncompensated care rate adjustment of not less than the
32 amount calculated pursuant to subparagraph (i) of this paragraph.]
33 (f) Any residual amount allocated for distribution to a classification
34 of diagnostic and treatment centers in accordance with this subdivision
35 shall be reallocated by the commissioner for distributions to the other
36 classifications based on remaining need.
37 4-b. (a) For periods on and after July first, two thousand three,
38 through June thirtieth, two thousand five, funds shall be made available
39 for adjustments to rates of payment made pursuant to paragraph (b) of
40 subdivision one of this section for eligible diagnostic and treatment
41 centers with less than two years of operating experience, and diagnostic
42 and treatment centers which have received certificate of need approval
43 on applications which indicate a significant increase in uninsured
44 visits, for the following periods and in the following aggregate
45 amounts:
46 (i) For the period July first, two thousand three through December
47 thirty-first, two thousand three, up to one million five hundred thou-
48 sand dollars;
49 (ii) For the period January first, two thousand four through December
50 thirty-first, two thousand four, up to three million dollars;
51 (iii) For the period January first, two thousand five through [Decem-
52 ber thirty-first] June thirtieth, two thousand [six] five, up to [three]
53 one million five hundred thousand dollars [for each calendar year rate
54 period;].
S. 2108--C 91 A. 4308--C
1 [(iv) For the period January first, two thousand seven through June
2 thirtieth, two thousand seven, up to one million five hundred thousand
3 dollars.]
4 (b) To be eligible for a rate adjustment pursuant to this section, a
5 diagnostic and treatment center shall be a voluntary, non-profit or
6 publicly sponsored diagnostic and treatment center providing a compre-
7 hensive range of primary health care services and be eligible to receive
8 a medicaid budgeted rate prior to April first of the applicable rate
9 adjustment period after which time, the department shall issue rate
10 adjustments pursuant to this subdivision for such periods. Rate adjust-
11 ments made pursuant to this subdivision shall be allocated based upon
12 each eligible facility's proportional share of costs for services
13 rendered to uninsured patients which have otherwise not been used for
14 establishing distributions pursuant to subdivision four-a of this
15 section. For the purposes of this subdivision costs shall be measured by
16 multiplying each facility's medicaid budgeted rate by the estimated
17 number of visits reported for services anticipated to be rendered to
18 uninsured patients meeting the aforementioned criteria, less any antic-
19 ipated patient service revenues received from such uninsured patients,
20 during the applicable rate adjustment period.
21 4-c. Notwithstanding any provision of law to the contrary, the commis-
22 sioner shall make additional payments for uncompensated care to volun-
23 tary non-profit diagnostic and treatment centers that are eligible for
24 distributions under subdivision four of this section in the following
25 amounts: for the period June first, two thousand six through December
26 thirty-first, two thousand six, in the amount of seven million five
27 hundred thousand dollars, and for the period January first, two thousand
28 seven through [June thirtieth] December thirty-first, two thousand
29 seven, [three] seven million [seven] five hundred [fifty] thousand
30 dollars, and for the period January first, two thousand eight through
31 March thirty-first, two thousand eight, in the amount of one million
32 eight hundred seventy-five thousand dollars, provided, however, that for
33 periods on and after January first, two thousand eight, such additional
34 payments shall be distributed to voluntary, non-profit diagnostic and
35 treatment centers and to public diagnostic and treatment centers in
36 accordance with paragraph (g) of subdivision four of this section. In
37 the event that federal financial participation is available for rate
38 adjustments pursuant to this section, the commissioner shall make such
39 payments as additional adjustments to rates of payment for voluntary
40 non-profit diagnostic and treatment centers that are eligible for
41 distributions under subdivision four-a of this section in the following
42 amounts: for the period June first, two thousand six through December
43 thirty-first, two thousand six, fifteen million dollars in the aggre-
44 gate, and for the period January first, two thousand seven through June
45 thirtieth, two thousand seven, seven million five hundred thousand
46 dollars in the aggregate. The amounts allocated pursuant to this para-
47 graph shall be aggregated with and distributed pursuant to the same
48 methodology applicable to the amounts allocated to such diagnostic and
49 treatment centers for such periods pursuant to subdivision four of this
50 section if federal financial participation is not available, or pursuant
51 to subdivision four-a of this section if federal financial participation
52 is available. Notwithstanding section three hundred sixty-eight-a of
53 the social services law, there shall be no local share in a medical
54 assistance payment adjustment under this subdivision.
55 5. Diagnostic and treatment centers shall furnish to the department
56 such reports and information as may be required by the commissioner to
S. 2108--C 92 A. 4308--C
1 assess the cost, quality, access to, effectiveness and efficiency of
2 uncompensated care provided. The council shall adopt rules and regu-
3 lations, subject to the approval of the commissioner, to establish
4 uniform reporting and accounting principles designed to enable diagnos-
5 tic and treatment centers to fairly and accurately determine and report
6 uncompensated care visits and the costs of uncompensated care. In order
7 to be eligible for an allocation of funds pursuant to this section, a
8 diagnostic and treatment center must be in compliance with uncompensated
9 care reporting requirements.
10 6. Notwithstanding any inconsistent provision of law to the contrary,
11 the availability or payment of funds to a diagnostic and treatment
12 center pursuant to this section shall not be admissible as a defense,
13 offset or reduction in any action or proceeding relating to any bill or
14 claim for amounts due for services provided by a diagnostic and treat-
15 ment center.
16 7. Revenue from distributions to a diagnostic and treatment center
17 pursuant to this section shall not be included in gross revenue received
18 for purposes of the assessments pursuant to section twenty-eight hundred
19 seven-d of this article, subject to the provisions of subdivision twelve
20 of section twenty-eight hundred seven-d of this article.
21 8. (a) For periods on or after January first, two thousand through
22 June thirtieth, two thousand three, payments made to an eligible diag-
23 nostic and treatment center pursuant to this section shall be reduced or
24 increased by an amount equal to the amount of any overpayments or under-
25 payments made against grants awarded pursuant to section seven of chap-
26 ter four hundred thirty-three of the laws of nineteen hundred ninety-
27 seven for the period three years prior to the annual awards made
28 pursuant to this section.
29 (b) The determination of such overpayments or underpayments shall be
30 based on the submission by eligible facilities of reports reflecting
31 actual uncompensated care data, as required by the commissioner, which
32 are attributable to prior periods. Submission of such reports is a
33 condition for an eligible facility's receipt of payments pursuant to
34 this section.
35 (c) For any periods in which a facility does not receive payments
36 pursuant to this section, the amount of any prior period overpayment may
37 be offset against payments for medical assistance made to such facility
38 pursuant to title eleven of article five of the social services law and
39 credited to funds allocated pursuant to this section. Any prior period
40 underpayment to an eligible facility may be paid to such facility in a
41 subsequent period.
42 9. Adjustments to rates of payment made pursuant to this section may
43 be added to rates of payment or made as aggregate payments to eligible
44 diagnostic and treatment centers and shall not be subject to subsequent
45 adjustment or reconciliation, provided, however, that in the event such
46 adjustments are made as aggregate payments, then notwithstanding any
47 law, rule or regulation to the contrary responsibility for the local
48 share of such aggregate payments shall be apportioned to a local social
49 services district based on the most recent geographic utilization data
50 available to the department for eligible diagnostic and treatment center
51 services for payments in accordance with subdivisions four-a and four-b
52 of this section for all diagnostic and treatment center services
53 provided in accordance with section three hundred sixty-five-a of the
54 social services law, regardless of whether another social services
55 district or the department may otherwise be responsible for furnishing
56 medical assistance to the eligible persons receiving such services.
S. 2108--C 93 A. 4308--C
1 § 56. Subdivision 3 and paragraphs (a) and (a-1) of subdivision 4 of
2 section 2807-k of the public health law, as amended by section 51 of
3 part B of chapter 58 of the laws of 2005, are amended to read as
4 follows:
5 3. (a) Each major public general hospital shall be allocated for
6 distribution from the pools established pursuant to this section for
7 each year through December thirty-first, two thousand [six] seven, an
8 amount equal to the amount allocated to such major public general hospi-
9 tal from the regional pool established pursuant to subdivision seventeen
10 of section twenty-eight hundred seven-c of this article for the period
11 January first, nineteen hundred ninety-six through December thirty-
12 first, nineteen hundred ninety-six.
13 (b) For the period January first, two thousand [seven] eight through
14 [June thirtieth] March thirty-first, two thousand [seven] eight each
15 major public general hospital shall be allocated for distribution from
16 the pools established pursuant to this section for such period, an
17 amount equal to [one-half] one-quarter the amount calculated pursuant to
18 paragraph (a) of this subdivision.
19 (a) From funds in the pool for each year, thirty-six million dollars
20 shall be reserved on an annual basis through December thirty-first, two
21 thousand [six] seven and [eighteen] nine million dollars shall be
22 reserved for the period January first, two thousand [seven] eight
23 through [June thirtieth] March thirty-first, two thousand [seven] eight,
24 for distribution as high need adjustments in accordance with subdivision
25 six of this section.
26 (a-1) From funds in the pool for each year, twenty-seven million
27 dollars shall be reserved on an annual basis for the periods January
28 first, two thousand through December thirty-first, two thousand [six]
29 seven and [thirteen] six million [five] seven hundred fifty thousand
30 dollars shall be reserved for the period January first, two thousand
31 [seven] eight through [June thirtieth] March thirty-first, two thousand
32 [seven] eight, for distribution in accordance with subdivision sixteen
33 of this section.
34 § 57. New York state makes annual distributions of $847,000,000 from
35 indigent care pools established pursuant to sections 2807-k and 2807-w
36 of the public health law to public and non-public general hospitals to
37 cover the cost of charity care and bad debts which are not eligible for
38 payment in whole or in part by a governmental agency, insurer or other
39 third party payor. Notwithstanding any contrary provision of law, and to
40 ensure transparency and accountability with respect to the distribution
41 and use of such funds, the commissioner of health, in consultation with
42 the chairs of the health committees of the senate and the assembly,
43 shall, by no later than July 1, 2007, establish a technical advisory
44 committee to assist in an evaluation of the type and amount of services
45 provided by hospitals in the state of New York and the costs incurred by
46 hospitals in relation to the receipt of indigent care distributions made
47 pursuant to sections 2807-k and 2807-w of the public health law, and the
48 relationship between indigent care distributions and the provisions of
49 subdivision 9-a of section 2807-k of the public health law. Such techni-
50 cal advisory committee shall include, among others, representatives of
51 public general hospitals, non-public general hospitals and consumers.
52 The commissioner of health, in conjunction with the chairs of the
53 health committees of the senate and the assembly shall hold public hear-
54 ings in different regions of the state to further such evaluation. The
55 commissioner shall, by no later than December 15, 2007, issue a report
S. 2108--C 94 A. 4308--C
1 setting forth the commissioner of health's conclusions and recommenda-
2 tions.
3 § 58. The opening paragraph, paragraph (a) of subdivision 1, and
4 subdivision 2 of section 2807-w of the public health law, as amended by
5 section 52 of part B of chapter 58 of the laws of 2005, are amended to
6 read as follows:
7 Funds allocated pursuant to paragraph (p) of subdivision one of
8 section twenty-eight hundred seven-v of this article, shall be deposited
9 as authorized and used for the purpose of making medicaid dispropor-
10 tionate share payments [within the limits established] of up to eighty-
11 two million dollars on an annualized basis pursuant to subdivision twen-
12 ty-one of section twenty-eight hundred seven-c of this article, for the
13 period January first, two thousand through [June thirtieth] March thir-
14 ty-first, two thousand [seven] eight, in accordance with the following:
15 (a) Each eligible rural hospital shall receive one hundred [four]
16 forty thousand dollars on an annualized basis for the periods January
17 first, two thousand through December thirty-first, two thousand [six]
18 seven and [seventy] thirty-five thousand dollars for the period January
19 first, two thousand [seven] eight through [June thirtieth] March thir-
20 ty-first, two thousand [seven] eight, provided as a disproportionate
21 share payment; provided, however, that if such payment pursuant to this
22 paragraph exceeds a hospital's applicable disproportionate share limit,
23 then the total amount in excess of such limit shall be provided as a
24 nondisproportionate share payment in the form of a grant directly from
25 this pool without allocation to the special revenue funds - other, indi-
26 gent care fund - 068, or any successor fund or account;
27 2. From the funds in the pool each year, thirty-six million dollars on
28 an annualized basis for the periods January first, two thousand through
29 December thirty-first, two thousand [six] seven and [eighteen] nine
30 million dollars for the period January first, two thousand [seven] eight
31 through [June thirtieth] March thirty-first, two thousand [seven] eight,
32 of the funds not distributed in accordance with subdivision one of this
33 section, shall be distributed in accordance with the formula set forth
34 in subdivision six of section twenty-eight hundred seven-k of this arti-
35 cle.
36 § 59. Subdivision 8-a of section 2807-j of the public health law, is
37 amended by adding a new paragraph (e) to read as follows:
38 (e) The commissioner may, as part of a final resolution of an audit
39 conducted pursuant to this subdivision, waive payment of interest and
40 penalties otherwise applicable pursuant to subdivision eight of this
41 section when amounts due as a result of such audit, other than such
42 waived penalties and interest, are paid in full to the commissioner or
43 the commissioner's designee within sixty days of the issuance of a final
44 audit report that is mutually agreed to by the commissioner and auditee,
45 provided, however, that if such final audit report is not so mutually
46 agreed upon, then neither the commissioner nor the auditee shall have
47 any obligations pursuant to this paragraph.
48 § 60. Subdivision 10 of section 2807-t of the public health law, is
49 amended by adding a new paragraph (e) to read as follows:
50 (e) The commissioner may, as part of a final resolution of an audit
51 conducted pursuant to this subdivision, waive payment of interest and
52 penalties otherwise applicable pursuant to subdivision eight of section
53 twenty-eight hundred seven-j of this article, when amounts due as a
54 result of such audit, other than such waived penalties and interest, are
55 paid in full to the commissioner or the commissioner's designee within
56 sixty days of the issuance of a final audit report that is mutually
S. 2108--C 95 A. 4308--C
1 agreed to by the commissioner and auditee, provided, however, that if
2 such final audit report is not so mutually agreed upon, then neither the
3 commissioner nor the auditee shall have any obligations pursuant to this
4 paragraph.
5 § 61. Intentionally omitted.
6 § 62. Paragraphs 1, 2, 3, and paragraph 5 of subsection (j) of section
7 4301 of the insurance law, paragraph 1 as amended and paragraph 2 as
8 added by section 8 of part A of chapter 1 of the laws of 2002, para-
9 graphs 3 and 5 as amended by section 2 of part J of chapter 82 of the
10 laws of 2002, are amended to read as follows:
11 (1) [No] Except as provided in this subsection, no medical expense
12 indemnity corporation, dental expense indemnity corporation, health
13 service corporation, or hospital service corporation shall be converted
14 into a corporation organized for pecuniary profit. Every such corpo-
15 ration shall be maintained and operated for the benefit of its members
16 and subscribers as a co-operative corporation.
17 (2) An article forty-three corporation which was the subject of an
18 initial opinion and decision issued by the superintendent on or before
19 December thirty-first, nineteen hundred ninety-nine, as the same may be
20 amended or one or more article forty-three corporations whose main
21 offices on January first, two thousand seven were located in one of the
22 counties listed in section one thousand two hundred sixty-two of the
23 public authorities law and its or their not-for-profit subsidiaries
24 (including, without limitation, any such subsidiary licensed as a health
25 service corporation pursuant to this chapter or as a health maintenance
26 organization organized pursuant to article forty-four of the public
27 health law), hereinafter referred to in the singular, may be converted
28 into [a corporation or other entity] one or more corporations or other
29 entities organized for pecuniary profit, or into [a for-profit organiza-
30 tion] one or more for-profit organizations, in any such case, in accord-
31 ance with the provisions of section seven thousand three hundred seven-
32 teen of this chapter.
33 (3) For the purposes of this subsection and section seven thousand
34 three hundred seventeen of this chapter, "public asset" shall mean
35 assets representing ninety-five percent of the fair market value of the
36 corporation seeking to convert into a corporation or other entity organ-
37 ized for pecuniary profit pursuant to paragraph two of this subsection;
38 provided, however, that for the purposes of the conversion of a corpo-
39 ration or corporations after the effective date of the chapter of the
40 laws of two thousand seven which amended this paragraph, "public asset"
41 shall mean assets representing ninety percent of the fair market value
42 of the corporation or corporations. Fair market value, as defined in
43 subsection (l) of section seven thousand three hundred seventeen of this
44 chapter, shall be determined as of the date the superintendent approves
45 the conversion transaction pursuant to subsection (f) of section seven
46 thousand three hundred seventeen of this chapter.
47 (5) For the purpose of this subsection and section seven thousand
48 three hundred seventeen of this chapter, "charitable asset" shall mean
49 assets representing five percent of the fair market value of the corpo-
50 ration seeking to convert into a corporation or other entity organized
51 for pecuniary profit pursuant to paragraph two of this subsection;
52 provided, however, that for the purposes of the conversion of a corpo-
53 ration or corporations after the effective date of the chapter of the
54 laws of two thousand seven which amended this paragraph, "charitable
55 asset" shall mean assets representing ten percent of the fair market
56 value of the corporation or corporations. Fair market value, as defined
S. 2108--C 96 A. 4308--C
1 in subsection (l) of section seven thousand three hundred seventeen of
2 this chapter, shall be determined as of the date the superintendent
3 approves the conversion transaction pursuant to subsection (f) of
4 section seven thousand three hundred seventeen of this chapter. If one
5 hundred percent of the stock is not transferred in connection with the
6 conversion transaction, the proportion of stock to cash that is distrib-
7 uted as the charitable asset shall be the same as the proportion of
8 stock to cash that is distributed as the public asset.
9 § 63. Paragraph 1 of subsection (a) of section 7317 of the insurance
10 law, as added by section 10 of part A of chapter 1 of the laws of 2002,
11 is amended to read as follows:
12 (1) An article forty-three corporation which was the subject of an
13 initial opinion and decision issued by the superintendent on or before
14 December thirty-first, nineteen hundred ninety-nine, as the same may be
15 amended or one or more article forty-three corporations whose main
16 offices on January first, two thousand seven were located in one of the
17 counties listed in section one thousand two hundred sixty-two of the
18 public authorities law and its or their not-for-profit subsidiaries
19 (including, without limitation, any such subsidiary licensed as a health
20 service corporation pursuant to this chapter or as a health maintenance
21 organization organized pursuant to article forty-four of the public
22 health law), hereinafter referred to in the singular, which seeks to
23 convert into [a corporation or other entity] one or more corporations or
24 other entities organized for pecuniary profit or into [a for-profit
25 organization] one or more for-profit organizations of any kind shall
26 submit a proposed plan of conversion to the superintendent for approval
27 pursuant to this section.
28 § 63-A. Paragraph 1 of subsection (k) of section 7317 of the insur-
29 ance law, as added by section 10 of part A of chapter 1 of the laws of
30 2002, is amended to read as follows:
31 (1) A charitable organization shall be established for the purpose of
32 receiving the charitable asset and shall operate as a tax exempt organ-
33 ization pursuant to section 501(c)(3) of the federal internal revenue
34 code for the purposes of receiving the charitable asset. Whether or not
35 the charitable organization is classified as a private foundation under
36 section 509 of the internal revenue code, as amended or any comparable
37 provision of any successor law, it shall be subject to the restrictions
38 and limitations that apply to private foundations in sections 4941
39 through 4945 of the federal internal revenue code, as amended or any
40 comparable provision of any successor law. The superintendent shall
41 provide in an opinion and decision approving the conversion for the
42 timely transfer of the charitable asset consistent with the purposes of
43 this chapter. In the case of the conversion of a corporation or corpo-
44 rations which occurs after the effective date of the chapter of the laws
45 of two thousand seven which amended this paragraph, the superintendent
46 shall provide in an opinion and decision approving such conversion for
47 the timely transfer of the charitable asset to the New York state health
48 foundation created pursuant to this subsection and in compliance with
49 all applicable provisions of this subsection.
50 § 64. Section 58 of part J of chapter 82 of the laws of 2002 amending
51 the environmental conservation law and other laws relating to certain
52 portions of funds borrowed, as amended by section 54 of part C of chap-
53 ter 109 of the laws of 2006, is amended to read as follows:
54 § 58. Notwithstanding any law, rule or regulation to the contrary, and
55 in accordance with section 4 of the state finance law, the commissioner
56 of health, with the approval of the director of the budget, is author-
S. 2108--C 97 A. 4308--C
1 ized to borrow two hundred million dollars from funds collected or to be
2 collected in pools established pursuant to paragraph (b) of subdivision
3 9 of section 2807-j of the public health law and section 2807-v of the
4 public health law and to transfer such funds to the state special reven-
5 ue funds - other, HCRA transfer fund, medical assistance account for
6 Medicaid purposes, including, but not limited to, disaster relief Medi-
7 caid, provided, however, that in the event that the commissioner of
8 health and the director of the budget subsequently determine prior to
9 the expiration date of such sections as set forth in section 138 of
10 chapter 1 of the laws of 1999 that additional funds are required to meet
11 obligations set forth in sections 2807-k, 2807-l, 2807-m or 2807-v of
12 the public health law, that up to two hundred million dollars shall be
13 transferred from the state general fund to pools established pursuant to
14 paragraph (b) of subdivision 9 of section 2807-j of the public health
15 law and section 2807-v of the public health law; and further provided
16 that the commissioner of health and director of the budget shall ensure
17 that the authorizations contained in this section and section fifty-nine
18 of this act shall in no event impede, limit or otherwise impair, in any
19 way, the implementation of, or the time frames or levels of financial
20 distributions for, any of the initiatives financed pursuant to section
21 2807-k, 2807-l, 2807-m or 2807-v of the public health law, provided
22 further, however, that for the period April 1, 2007 through March 31,
23 [2009] 2011, the commissioner of health and the director of the budget
24 shall in no event be required to return to such pools any portion of the
25 funds borrowed pursuant to this section.
26 § 65. Subdivision 5 of section 97-cccc of the state finance law, as
27 amended by section 55 of part C of chapter 109 of the laws of 2006, is
28 amended to read as follows:
29 5. Notwithstanding any other provision of this section or any other
30 contrary provision of law, for the period April first, two thousand
31 seven through March thirty-first, two thousand [nine] eleven, the
32 provisions of subdivision three of this section shall be suspended and
33 have no force and effect.
34 § 65-a. Section 48 of part C of chapter 109 of the laws of 2006,
35 amending the social services law and other laws relating to Medicaid
36 reimbursement rate settings, is amended to read as follows:
37 § 48. Notwithstanding any contrary provision of law, the commissioner
38 of health shall, by no later than [October 1, 2006] May 15, 2007, estab-
39 lish a workgroup to investigate and develop recommendations pertaining
40 to Medicaid reimbursement rate-setting for residential health care
41 facilities for future periods, including, but not limited to, the
42 following areas:
43 (a) the appropriate reimbursement for capital costs for those facili-
44 ties which have received reimbursement reflecting one hundred percent of
45 capital depreciation;
46 (b) potential mechanisms for reimbursement of costs incurred by facil-
47 ities with regard to the employment of nursing staff provided by inde-
48 pendent companies;
49 (c) reimbursement of costs related to insurance;
50 (d) conversion from the RUG II patient classification system to the
51 "minimum data set" (RUG-III) patient classification system;
52 (e) reimbursement for facilities providing care to specialized popu-
53 lations with specialized care needs; [and]
54 (f) corridors applicable to the statewide mean prices as utilized for
55 rate-setting purposes[.];
S. 2108--C 98 A. 4308--C
1 (g) the reasons underlying the existing proportion of Medicaid
2 patients to non-Medicaid patients in New York facilities;
3 (h) issues related to Medicare;
4 (i) impact of planned rightsizing of the acute care system;
5 (j) impact of planned rightsizing of nursing home system;
6 (k) impact of using Medicaid only case mix; and
7 (l) other issues as determined by the commissioner.
8 The members of the workgroup shall include department of health staff
9 and representatives of statewide associations representing the residen-
10 tial health care facility industry in New York [and], organizations
11 representing employees, and associations with less than a statewide
12 membership shall have the ability to present information to the work-
13 group and participate in the discussions on the issues outlined in this
14 section. The commissioner of health shall appoint the chair of the
15 workgroup. An initial report setting forth the workgroup's conclusions
16 and recommendations shall be submitted to the commissioner of health by
17 no later than [June] January 1, [2007] 2008 and a subsequent report
18 shall be submitted to the commissioner of health no later than June [1]
19 15, 2008. Thereafter such workgroup shall continue until January 1,
20 2009, or as determined by the commissioner of health.
21 § 65-b. Subdivision 1 of section 2807-c of the public health law is
22 amended by adding a new paragraph (k) to read as follows:
23 (k) Subject to the availability of federal financial participation,
24 the commissioner shall adjust inpatient rates of payment for non-public
25 general hospitals located in a city with a population of more than one
26 million persons for the following periods and in the following amounts
27 in order to ensure meaningful access to the hospital's services and
28 reasonable accommodation for all medicaid patients who require language
29 assistance:
30 (i) for the period July first, two thousand seven through December
31 thirty-first, two thousand seven, thirty-eight million dollars shall be
32 allocated proportionally to such hospitals based on fifty percent of
33 each such hospital's reported general clinic medicaid visits and fifty
34 percent on each such hospital's reported medicaid inpatient discharges,
35 as reported in each hospital's two thousand four institutional cost
36 report, as submitted to the department prior to November first, two
37 thousand six, to the total of all such general clinic visits reported by
38 all such hospitals.
39 (ii) for the period April first, two thousand eight through March
40 thirty-first, two thousand nine, thirty-eight million dollars shall be
41 allocated for such purpose to such hospitals in accordance with regu-
42 lations promulgated by the commissioner and which shall provide that up
43 to thirty percent of such funds shall be allocated proportionally, based
44 on the number of foreign languages utilized by one or more percent of
45 the residents in each hospital total service area population.
46 § 65-c. Section 4 of chapter 495 of the laws of 2004, amending the
47 insurance law and the public health law relating to the New York state
48 health insurance continuation assistance demonstration project, as
49 amended by section 86 of part B of chapter 58 of the laws of 2005, is
50 amended to read as follows:
51 § 4. This act shall take effect on the sixtieth day after it shall
52 have become a law; provided, however, that this act shall remain in
53 effect until July 1, [2007] 2009 when upon such date the provisions of
54 this act shall expire and be deemed repealed; provided, further, that a
55 displaced worker shall be eligible for continuation assistance retroac-
56 tive to July 1, 2004.
S. 2108--C 99 A. 4308--C
1 § 65-d. Paragraph 4 of subsection (a) of section 3216 of the insurance
2 law, subparagraph (A) as amended by chapter 93 of the laws of 1989, is
3 amended to read as follows:
4 (4) "Dependent children" [includes] (A) shall include any children
5 under a specified age which shall not exceed age nineteen except:
6 [(A)] (i) Any unmarried dependent child, regardless of age, who is
7 incapable of self-sustaining employment by reason of mental illness,
8 developmental disability, or mental retardation as defined in the mental
9 hygiene law, or physical handicap and who became so incapable prior to
10 the age at which dependent coverage would otherwise terminate, shall be
11 included in coverage subject to any pre-existing conditions limitation
12 applicable to other dependents.
13 [(B)] (ii) Any unmarried student at an accredited institution of
14 learning may be considered a dependent child until attaining age twen-
15 ty-three.
16 (B) may include, at the option of the insurer, any unmarried child
17 until attaining age twenty-five.
18 § 65-e. Paragraph 1 of subsection (d) of section 4304 of the insurance
19 law, as amended by chapter 312 of the laws of 2002, is amended to read
20 as follows:
21 (1) No contract issued pursuant to this section shall entitle more
22 than one person to benefits except that a contract issued and marked as
23 a "family contract" may provide that benefits will be furnished to a
24 husband and wife, or husband, wife and their dependent child or chil-
25 dren, or any child or children not over nineteen years of age, provided
26 that an unmarried student at an accredited institution of learning may
27 be considered a dependent until he becomes twenty-three years of age,
28 provided that the coverage of any such "family contract" may include, at
29 the option of the insurer, any unmarried child until attaining age twen-
30 ty-five, and provided also that the coverage of any such "family
31 contract" shall include any other unmarried child, regardless of age,
32 who is incapable of self-sustaining employment by reason of mental
33 illness, developmental disability, mental retardation, as defined in the
34 mental hygiene law, or physical handicap and who became so incapable
35 prior to attainment of the age at which dependent coverage would other-
36 wise terminate, so that such child may be considered a dependent.
37 Notwithstanding any rule, regulation or law to the contrary, any "family
38 contract" shall provide that coverage of newborn infants, including
39 newly born infants adopted by the insured or subscriber if such insured
40 or subscriber takes physical custody of the infant upon such infant's
41 release from the hospital and files a petition pursuant to section one
42 hundred fifteen-c of the domestic relations law within thirty days of
43 birth; and provided further that no notice of revocation to the adoption
44 has been filed pursuant to section one hundred fifteen-b of the domestic
45 relations law and consent to the adoption has not been revoked, shall be
46 effective from the moment of birth for injury or sickness including the
47 necessary care and treatment of medically diagnosed congenital defects
48 and birth abnormalities including premature birth, except that in cases
49 of adoption, coverage of the initial hospital stay shall not be required
50 where a birth parent has insurance coverage available for the infant's
51 care. This provision regarding coverage of newborn infants shall not
52 apply to two person coverage. In the case of individual or two person
53 coverages the corporation must also permit the person to whom the policy
54 is issued to elect such coverage of newborn infants from the moment of
55 birth. If notification and/or payment of an additional premium or
56 contribution is required to make coverage effective for a newborn
S. 2108--C 100 A. 4308--C
1 infant, the coverage may provide that such notice and/or payment be made
2 within no less than thirty days of the day of birth to make coverage
3 effective from the moment of birth. This election shall not be required
4 in the case of student insurance or where the group remitting agent's
5 plan does not provide coverage for dependent children.
6 § 65-f. Subdivision 1 of section 2807-c of the public health law is
7 amended by adding a new paragraph (l) to read as follows:
8 (l) Effective for periods on and after July first, two thousand seven:
9 (i) Subject to the availability of federal financial participation,
10 the commissioner shall adjust inpatient medical assistance rates of
11 payment calculated pursuant to this section for general hospitals
12 located in the counties of Nassau and Suffolk in accordance with the
13 methodology set forth in subparagraph (ii) of this paragraph. For
14 purposes of this paragraph, "medicaid inpatient discharges" shall mean
15 the total number of such general hospital's discharges where the
16 patients were eligible for payments under the medical assistance
17 program pursuant to title eleven of article five of the social services
18 law, including those enrolled in health maintenance organizations, and
19 patients eligible for payments under the family health plus program
20 pursuant to title eleven-D of article five of the social services law,
21 based on data reported in such hospital's institutional cost report
22 submitted for the two thousand four period and filed with the depart-
23 ment by November first, two thousand six.
24 (ii) The amount of rate adjustments calculated pursuant to this para-
25 graph shall not exceed five million dollars in the aggregate annually.
26 Such amount shall be allocated proportionally based on the relative
27 numbers of medicaid discharges among those general hospitals eligible
28 for rate adjustments in accordance with subparagraph (i) of this para-
29 graph based on each such hospital's reported medical assistance data
30 specified in subparagraph (i) of this paragraph. Such amounts shall be
31 included as an add-on to medical assistance inpatient rates of payment,
32 excluding exempt unit rates, and shall not be reconciled to reflect
33 changes in medical assistance utilization between two thousand four and
34 the current rate year.
35 § 66. Notwithstanding any inconsistent provision of law, rule or regu-
36 lation, for purposes of implementing the provisions of the public health
37 law and the social services law, references to titles XIX and XXI of the
38 federal social security act in the public health law and the social
39 services law shall be deemed to include and also to mean any successor
40 titles thereto under the federal social security act.
41 § 67. Notwithstanding any inconsistent provision of law, rule or regu-
42 lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b of section
43 2807 of the public health law and section 18 of chapter 2 of the laws of
44 1988, as they relate to time frames for notice, approval or certif-
45 ication of rates of payment, are hereby suspended and shall, for
46 purposes of implementing the provisions of this act, be deemed to have
47 been without any force or effect from and after November 1, 2006 for
48 such rates effective for the period January 1, 2007 through December 31,
49 2007.
50 § 68. Severability clause. If any clause, sentence, paragraph, subdi-
51 vision, section or part of this act shall be adjudged by any court of
52 competent jurisdiction to be invalid, such judgment shall not affect,
53 impair or invalidate the remainder thereof, but shall be confined in its
54 operation to the clause, sentence, paragraph, subdivision, section or
55 part thereof directly involved in the controversy in which such judgment
56 shall have been rendered. It is hereby declared to be the intent of the
S. 2108--C 101 A. 4308--C
1 legislature that this act would have been enacted even if such invalid
2 provisions had not been included herein.
3 § 69. This act shall take effect immediately and shall be deemed to
4 have been in full force and effect on and after April 1, 2007; provided,
5 however, that:
6 1. Any rules or regulations necessary to implement the provisions of
7 this act may be promulgated and any procedures, forms, or instructions
8 necessary for such implementation may be adopted and issued on or after
9 the date this act shall have become a law;
10 2. This act shall not be construed to alter, change, affect, impair or
11 defeat any rights, obligations, duties or interests accrued, incurred or
12 conferred prior to the enactment of this act;
13 3. The commissioner of health and the superintendent of insurance and
14 any appropriate council may take any steps necessary to implement this
15 act prior to its effective date;
16 4. Notwithstanding any inconsistent provision of the state administra-
17 tive procedure act or any other provision of law, rule or regulation,
18 the commissioner of health and the superintendent of insurance and any
19 appropriate council is authorized to adopt or amend or promulgate on an
20 emergency basis any regulation he or she or such council determines
21 necessary to implement any provision of this act on its effective date;
22 5. The provisions of this act shall become effective notwithstanding
23 the failure of the commissioner of health or the superintendent of
24 insurance or any council to adopt or amend or promulgate regulations
25 implementing this act;
26 6. The amendments to section 2807-j of the public health law made by
27 sections three, thirteen and fifty-nine of this act shall not affect the
28 expiration of such section and shall be deemed to expire therewith;
29 7. The amendments to section 2807-s of the public health law made by
30 sections eight, nine, ten, eleven, twenty-one and twenty-two of this act
31 shall not affect the expiration of such section and shall be deemed to
32 expire therewith;
33 8. The amendments to section 2807-t of the public health law made by
34 section sixty of this act shall not affect the expiration of such
35 section and shall be deemed to expire therewith;
36 9. The amendments to paragraph (i-1) of subdivision 1 of section
37 2807-v of the public health law made by section six of this act shall
38 not affect the repeal of such paragraph and shall be deemed to be
39 repealed therewith;
40 10. The amendments to subdivision 10 of section 2807-t of the public
41 health law made by section sixty-one of this act shall not affect the
42 expiration of such section and shall be deemed to expire therewith;
43 11. The amendments to paragraph (d) of subdivision 18 of section
44 2807-c of the public health law made by section twelve of this act shall
45 not affect the expiration of such paragraph and shall be deemed to
46 expire therewith;
47 12. The amendments to paragraph (a-2) of subdivision 1 of section
48 2807-c of the public health law made by section thirty-seven-a of this
49 act shall not affect the repeal of such paragraph and shall be deemed to
50 be repealed therewith; and
51 13. The amendments to section 364-i of the social services law made by
52 section twenty-nine-i of this act shall not affect the expiration of
53 such section and shall be deemed to expire therewith.
54 PART B
S. 2108--C 102 A. 4308--C
1 Section 1. Subparagraph 2 of paragraph (a) of subdivision 1 of section
2 250 of the elder law, as amended by section 33 of part C of chapter 109
3 of the laws of 2006, is amended to read as follows:
4 (2) The sum of the upper limit set by the centers for medicare and
5 medicaid services for such multiple source drug, or average wholesale
6 price discounted by [twenty] twenty-five percent when no upper limit has
7 been established by the centers for medicare and medicaid services for
8 such multiple source drug, plus a dispensing fee as defined in paragraph
9 (c) of this subdivision.
10 § 2. Subparagraph 1 of paragraph (b) of subdivision 1 of section 250
11 of the elder law, as amended by section 34 of part C of chapter 109 of
12 the laws of 2006, is amended to read as follows:
13 (1) Average wholesale price discounted by [thirteen and twenty-five
14 hundredths of one] fourteen percent, plus a dispensing fee as defined in
15 paragraph (c) of this subdivision, or
16 § 3. Paragraph (e) of subdivision 3 of section 242 of the elder law,
17 as amended by section 20 of part B of chapter 57 of the laws of 2006, is
18 amended and three new paragraphs (f), (g) and (h) are added to read as
19 follows:
20 (e) As a condition of continued eligibility for benefits under this
21 title, if a program participant's income indicates that the participant
22 could be eligible for [a full premium] an income-related subsidy under
23 section 1860D-14 of the federal social security act, a program partic-
24 ipant is required to provide, and to authorize the elderly pharmaceu-
25 tical insurance coverage program to obtain, any information or documen-
26 tation required to establish the participant's eligibility for such
27 subsidy. The elderly pharmaceutical insurance coverage program shall
28 make a reasonable effort to notify the program participant of his or her
29 need to provide any of the above required information. After a reason-
30 able effort has been made to contact the participant, a participant
31 shall be notified in writing that he or she has sixty days to provide
32 such required information. If such information is not provided within
33 the sixty day period, the participant's coverage may be terminated. [The
34 elderly pharmaceutical insurance coverage program is authorized and
35 directed to conduct an enrollment program to identify, encourage and
36 facilitate, in as prompt and streamlined a fashion as possible, the
37 enrollment of program participants who are found eligible for such
38 subsidy for enrollment into part D of such act, unless such enrollment
39 will result in significant additional financial liability on behalf of
40 the participant or in the loss of any health coverage through a union or
41 employer plan for the participant, the participant's spouse or other
42 dependent. Provided, however, that an eligible program participant's
43 decision to disenroll from a prescription drug plan or MA-PD plan shall
44 not impact their continued eligibility for benefits under this title.
45 Provided further, however, a participant shall not be prevented from
46 receiving his or her drugs immediately at the pharmacy under the elderly
47 pharmaceutical insurance coverage program as a result of such partic-
48 ipant's enrollment in Medicare part D. In order to maximize prescription
49 drug coverage under Part D of title XVIII of the federal social security
50 act, the elderly pharmaceutical insurance coverage program is authorized
51 to represent program participants under this title in the pursuit of
52 such coverage. Such representation shall not result in any additional
53 financial liability on behalf of such program participants and shall
54 include, but not be limited to, the following actions:
55 (i) application for the premium and cost-sharing subsidies on behalf
56 of eligible program participants;
S. 2108--C 103 A. 4308--C
1 (ii) enrollment in a prescription drug plan or MA-PD plan; the elderly
2 pharmaceutical insurance coverage program shall provide program partic-
3 ipants with prior written notice of, and the opportunity to decline,
4 such enrollment;
5 (iii) pursuit of appeals, grievances, or coverage determinations.]
6 (f) As a condition of continued eligibility for benefits under this
7 title, if a program participant is eligible for Medicare part D drug
8 coverage under section 1860D of the federal social security act, the
9 participant is required to enroll in Medicare part D at the first avail-
10 able enrollment period and to maintain such enrollment. This require-
11 ment shall be waived if such enrollment would result in significant
12 additional financial liability by the participant, including, but not
13 limited to, individuals in a Medicare advantage plan whose cost sharing
14 would be increased, or if such enrollment would result in the loss of
15 any health coverage through a union or employer plan for the partic-
16 ipant, the participant's spouse or other dependent. The elderly pharma-
17 ceutical insurance coverage program shall provide premium assistance for
18 all participants enrolled in Medicare part D as follows:
19 (i) for participants with comprehensive coverage under section two
20 hundred forty-seven of this title, the elderly pharmaceutical insurance
21 coverage program shall pay for the portion of the part D monthly premium
22 that is the responsibility of the participant. Such payment shall be
23 limited to the low-income benchmark premium amount established by the
24 federal centers for Medicare and Medicaid services and any other amount
25 which such agency establishes under its de minimus premium policy,
26 except that such payments made on behalf of participants enrolled in a
27 Medicare advantage plan may exceed the low-income benchmark premium
28 amount if determined to be cost effective to the program.
29 (ii) for participants with catastrophic coverage under section two
30 hundred forty-eight of this title, the elderly pharmaceutical insurance
31 coverage program shall credit the participant's annual personal covered
32 drug expenditure amount required under this title by an amount equal to
33 the annual low-income benchmark premium amount established by the
34 centers for Medicare and Medicaid services, prorated for the remaining
35 portion of the participant's elderly pharmaceutical insurance coverage
36 program coverage period. The elderly pharmaceutical insurance coverage
37 program shall, at appropriate times, notify participants with
38 catastrophic coverage under section two hundred forty-seven of this
39 title of their right to coordinate the annual coverage period with that
40 of Medicare part D, along with the possible advantages and disadvantages
41 of doing so.
42 (g) The elderly pharmaceutical insurance coverage program is author-
43 ized and directed to conduct an enrollment program to facilitate, in as
44 prompt and streamlined a fashion as possible, the enrollment into Medi-
45 care part D of program participants who are required by the provisions
46 of this section to enroll in part D. Provided, however, that a partic-
47 ipant shall not be prevented from receiving his or her drugs immediately
48 at the pharmacy under the elderly pharmaceutical insurance coverage
49 program as a result of such participant's enrollment in Medicare part D.
50 (h) In order to maximize prescription drug coverage under Medicare
51 part D, the elderly pharmaceutical insurance coverage program is author-
52 ized to represent program participants under this title in the pursuit
53 of such coverage. Such representation shall not result in any additional
54 financial liability on behalf of such program participants and shall
55 include, but not be limited to, the following actions:
S. 2108--C 104 A. 4308--C
1 (i) application for the premium and cost-sharing subsidies on behalf
2 of eligible program participants;
3 (ii) enrollment in a prescription drug plan or MA-PD plan; the elderly
4 pharmaceutical insurance coverage program shall provide program partic-
5 ipants with prior written notice of, and the opportunity to decline such
6 facilitated enrollment subject, however, to the provisions of paragraph
7 (f) of this subdivision;
8 (iii) pursuit of appeals, grievances, or coverage determinations.
9 § 4. Intentionally omitted.
10 § 5. Intentionally omitted.
11 § 6. Intentionally omitted.
12 § 7. Section 4 of part X2 of chapter 62 of the laws of 2003, amending
13 the public health law relating to allowing for the use of funds of the
14 office of professional medical conduct for activities of the patient
15 health information and quality improvement act of 2000, as amended by
16 section 21 of part B of chapter 57 of the laws of 2006, is amended to
17 read as follows:
18 § 4. This act shall take effect immediately; provided that the
19 provisions of section one of this act shall be deemed to have been in
20 full force and effect on and after April 1, 2003, and shall expire March
21 31, [2007] 2008 when upon such date the provisions of such section shall
22 be deemed repealed.
23 § 8. Intentionally omitted.
24 § 9. Section 5 of part G of chapter 56 of the laws of 2000, amending
25 the public health law, the general business law and the insurance law
26 relating to the sale and possession of hypodermic syringes and needles,
27 as amended by chapter 16 of the laws of 2003, is amended to read as
28 follows:
29 § 5. This act shall take effect January 1, 2001 and shall remain in
30 full force and effect until September 1, [2007] 2011 when upon such date
31 the provisions of this act shall be deemed repealed; provided, however,
32 that effective immediately the commissioner of health is authorized to
33 promulgate any rules and regulations necessary for the timely implemen-
34 tation of this act on such effective date.
35 § 9-a. Section 3381 of the public health law, as amended by section 1
36 of part G of chapter 56 of the laws of 2000, subdivision 7 as added by
37 chapter 668 of the laws of 2002, is amended to read as follows:
38 § 3381. Sale and possession of hypodermic syringes and hypodermic
39 needles. 1. It shall be unlawful for any person to sell or furnish to
40 another person or persons, a hypodermic syringe or hypodermic needle
41 except:
42 (a) pursuant to a written prescription of a practitioner; or
43 (b) to persons who have been authorized by the commissioner to obtain
44 and possess such instruments; or
45 (c) by a pharmacy licensed under article one hundred thirty-seven of
46 the education law, health care facility licensed under article twenty-
47 eight of this chapter or a health care practitioner who is otherwise
48 authorized to prescribe the use of hypodermic needles or syringes within
49 his or her scope of practice; provided, however, that such sale or
50 furnishing: (i) shall only be to a person eighteen years of age or
51 older; (ii) shall be limited to a quantity of ten or less hypodermic
52 needles or syringes; and (iii) shall be in accordance with subdivision
53 [six] five of this section.
54 2. It shall be unlawful for any person to obtain or possess a hypo-
55 dermic syringe or hypodermic needle unless such possession has been
S. 2108--C 105 A. 4308--C
1 authorized by the commissioner or is pursuant to a written prescription,
2 or is pursuant to subdivision [six] five of this section.
3 3. Any person selling or furnishing a hypodermic syringe or hypodermic
4 needle pursuant to a prescription shall record upon the face of the
5 prescription, over his signature, the date of the sale or furnishing of
6 the hypodermic syringe or hypodermic needle. Such prescription shall be
7 retained on file for a period of five years and be readily accessible
8 for inspection by any public officer or employee engaged in the enforce-
9 ment of this section. Such prescription may be refilled not more than
10 the number of times specifically authorized by the prescriber upon the
11 prescription, provided however no such authorization shall be effective
12 for a period greater than two years from the date the prescription is
13 signed.
14 4. The commissioner shall, subject to subdivision [six] five of this
15 section, designate persons, or by regulation, classes of persons who may
16 obtain hypodermic syringes and hypodermic needles without prescription
17 and the manner in which such transactions may take place and the records
18 thereof which shall be maintained.
19 [5. (a) The commissioner, in consultation with the commissioner of
20 alcoholism and substance abuse services, the commissioner of the depart-
21 ment of correctional services, the commissioner of the division of crim-
22 inal justice services, the commissioner of the office of general
23 services, the commissioner of the office of mental health, the commis-
24 sioner of the office of mental retardation and developmental disabili-
25 ties and the director of the division for youth shall develop a limited
26 number of cooperative pilot projects to test the practicality and effec-
27 tiveness of the distribution of syringes for human injection which are
28 intended for single use and which are non-reusable. Such pilot projects
29 shall be demonstrated throughout the state in high risk clinical
30 settings of state operated facilities such as prisons, hospitals, youth
31 detention facilities, developmental centers and other state operated
32 facilities as the commissioner, in consultation with the above listed
33 commissioners and directors determine appropriate.
34 (b) On or before June thirtieth, nineteen hundred ninety-eight, the
35 commissioner and the commissioners and directors listed in paragraph (a)
36 of this subdivision shall evaluate the pilot projects established pursu-
37 ant to this subdivision, and shall submit a report of his or her evalu-
38 ation to the governor, the temporary president of the senate, and the
39 speaker of the assembly.
40 6.] 5. (a) A person eighteen years of age or older may obtain and
41 possess a hypodermic syringe or hypodermic needle pursuant to paragraph
42 (c) of subdivision one of this section.
43 (b) Subject to regulations of the commissioner, a pharmacy licensed
44 under article one hundred thirty-seven of the education law, a health
45 care facility licensed under article twenty-eight of this chapter or a
46 health care practitioner who is otherwise authorized to prescribe the
47 use of hypodermic needles or syringes within his or her scope of prac-
48 tice, may obtain and possess hypodermic needles or syringes for the
49 purpose of selling or furnishing them pursuant to paragraph (c) of
50 subdivision one of this section or for the purpose of disposing of them,
51 provided that such pharmacy, health care facility or health care practi-
52 tioner has registered with the department.
53 (c) Sale or furnishing of hypodermic syringes or hypodermic needles to
54 direct consumers pursuant to this subdivision by a pharmacy, health care
55 facility, or health care practitioner shall be accompanied by a safety
56 insert. Such safety insert shall be developed or approved by the commis-
S. 2108--C 106 A. 4308--C
1 sioner and shall include, but not be limited to, (i) information on the
2 proper use of hypodermic syringes and hypodermic needles; (ii) the risk
3 of blood borne diseases that may result from the use of hypodermic
4 syringes and hypodermic needles; (iii) methods for preventing the trans-
5 mission or contraction of blood borne diseases; (iv) proper hypodermic
6 syringe and hypodermic needle disposal practices; (v) information on the
7 dangers of injection drug use, and how to access drug treatment; (vi) a
8 toll-free phone number for information on the human immunodeficiency
9 virus; and (vii) information on the safe disposal of hypodermic syringes
10 and hypodermic needles including the relevant provisions of the environ-
11 mental conservation law relating to the unlawful release of regulated
12 medical waste. The safety insert shall be attached to or included in the
13 hypodermic syringe and hypodermic needle packaging, or shall be given to
14 the purchaser at the point of sale or furnishing in brochure form.
15 (d) In addition to the requirements of paragraph (c) of subdivision
16 one of this section, a pharmacy licensed under article one hundred thir-
17 ty-seven of the education law may sell or furnish hypodermic needles or
18 syringes only if such pharmacy: (i) does not advertise to the public the
19 availability for retail sale or furnishing of hypodermic needles or
20 syringes without a prescription; and (ii) at any location where hypo-
21 dermic needles or syringes are kept for retail sale or furnishing,
22 stores such needles and syringes in a manner that makes them available
23 only to authorized personnel and not openly available to customers.
24 (e) The commissioner shall promulgate rules and regulations necessary
25 to implement the provisions of this subdivision which shall include a
26 requirement that such pharmacies, health care facilities and health care
27 [practioners] practitioners cooperate in a safe disposal of used hypo-
28 dermic needles or syringes.
29 (f) The commissioner may, upon the finding of a violation of this
30 section, suspend for a determinate period of time the sale or furnishing
31 of syringes by a specific entity.
32 [7.] 6. The provisions of this section shall not apply to farmers
33 engaged in livestock production or to those persons supplying farmers
34 engaged in livestock production, provided that:
35 (a) Hypodermic syringes and needles shall be stored in a secure,
36 locked storage container.
37 (b) At any time the department may request a document outlining:
38 (i) the number of hypodermic needles and syringes purchased over the
39 past calendar year;
40 (ii) a record of all hypodermic needles used over the past calendar
41 year; and
42 (iii) a record of all hypodermic needles and syringes destroyed over
43 the past calendar year.
44 (c) Hypodermic needles and syringes shall be destroyed in a manner
45 consistent with the provisions set forth in section thirty-three hundred
46 eighty-one-a of this article.
47 § 10. Section 97-eeee of the state finance law, as added by section 1
48 of part AA of chapter 61 of the laws of 2005, is amended to read as
49 follows:
50 § 97-eeee. Federal-state health reform partnership program [fund]
51 account. 1. There is hereby established in the [sole] joint custody of
52 the state comptroller and the commissioner of taxation and finance a
53 [fund] miscellaneous special revenue account to be known as the "feder-
54 al-state health reform partnership program [fund] account".
55 2. The [fund] account shall consist of those monies received from the
56 federal government for additional medical assistance revenues or savings
S. 2108--C 107 A. 4308--C
1 achieved under the federal-state health reform partnership program or
2 monies earned by the state and received from the federal government to
3 support expenditures under the federal-state health reform partnership
4 program and/or successor program pursuant to section 1115 of the federal
5 social security act.
6 3. Notwithstanding any provision of law to the contrary, where and to
7 the extent that federal revenues or savings under subdivision two of
8 this section made available to the state under any such New York State
9 section 1115 waiver or amendment thereto, such revenues or savings shall
10 be deposited in the [fund] account.
11 4. All monies shall remain in such [fund] account unless otherwise
12 disbursed pursuant to appropriation by the legislature.
13 § 11. Subdivision 1 of section 903 of the education law, as amended by
14 chapter 477 of the laws of 2004, is amended to read as follows:
15 1. A health certificate shall be furnished by each student in the
16 public schools upon his or her entrance in such schools and upon his or
17 her entry into the grades prescribed by the commissioner in regulations,
18 provided that such regulations shall require such certificates at least
19 twice during the elementary grades and twice in the secondary grades. An
20 examination and health history of any child may be required by the local
21 school authorities at any time in their discretion to promote the educa-
22 tional interests of such child. Each certificate shall be signed by a
23 duly licensed physician, physician assistant, or nurse practitioner, who
24 is authorized by law to practice in this state, and consistent with any
25 applicable written practice agreement, or by a duly licensed physician,
26 physician assistant, or nurse practitioner, who is authorized to prac-
27 tice in the jurisdiction in which the examination was given, provided
28 that the commissioner has determined that such jurisdiction has stand-
29 ards of licensure and practice comparable to those of New York. Each
30 such certificate shall describe the condition of the student when the
31 examination was made, which shall not be more than twelve months prior
32 to the commencement of the school year in which the examination is
33 required, and shall state whether such student is in a fit condition of
34 health to permit his or her attendance at the public schools. Each such
35 certificate shall also state the student's body mass index (BMI) and
36 weight status category. For purposes of this section, BMI is computed as
37 the weight in kilograms divided by the square of height in meters or the
38 weight in pounds divided by the square of height in inches multiplied by
39 a conversion factor of 703. Weight status categories for children and
40 adolescents shall be as defined by the commissioner of health. In all
41 school districts such physician, physician assistant or nurse practi-
42 tioner shall determine whether a one-time test for sickle cell anemia is
43 necessary or desirable and he or she shall conduct such a test and the
44 certificate shall state the results. Within thirty days after the
45 student's entrance in such schools or grades, the certificate shall be
46 submitted to the principal or his or her designee and shall be filed in
47 the student's cumulative health record. If such student does not present
48 a health certificate as required in this section, unless he or she has
49 been accommodated on religious grounds, the principal or the principal's
50 designee shall cause a notice to be sent to the parents or person in
51 parental relationship to such student that if the required health
52 certificate is not furnished within thirty days from the date of such
53 notice, an examination will be made of such student, as provided in this
54 article. Each school and school district chosen as part of an appropri-
55 ate sampling methodology shall participate in surveys directed by the
56 commissioner of health pursuant to the public health law in relation to
S. 2108--C 108 A. 4308--C
1 students' BMI and weight status categories as reported on the school
2 health certificate and which shall be subject to audit by the commis-
3 sioner of health. Such surveys shall contain the information required
4 pursuant to this subdivision in relation to students' BMI and weight
5 status categories in aggregate. Parents or other persons in parental
6 relation to a student may refuse to have the student's BMI and weight
7 status category included in such survey. Each school and school district
8 shall provide the commissioner of health with any information, records
9 and reports he or she may require for the purpose of such audit. The
10 BMI and weight status survey and audit as described in this subdivision
11 shall be conducted consistent with confidentiality requirements imposed
12 by federal law.
13 § 12. Subdivision 1 of section 904 of the education law, as amended by
14 chapter 477 of the laws of 2004, is amended to read as follows:
15 1. Each principal of a public school, or his or her designee, shall
16 report to the director of school health services having jurisdiction
17 over such school, the names of all students who have not furnished
18 health certificates as provided in section nine hundred three of this
19 article, or who are children with disabilities, as defined by article
20 eighty-nine of this chapter, and the director of school health services
21 shall cause such students to be separately and carefully examined and
22 tested to ascertain whether any student has defective sight or hearing,
23 or any other physical disability which may tend to prevent him or her
24 from receiving the full benefit of school work, or from requiring a
25 modification of such work to prevent injury to the student or from
26 receiving the best educational results. Each examination shall also
27 include a calculation of the student's body mass index (BMI) and weight
28 status category. For purposes of this section, BMI is computed as the
29 weight in kilograms divided by the square of height in meters or the
30 weight in pounds divided by the square of height in inches multiplied by
31 a conversion factor of 703. Weight status categories for children and
32 adolescents shall be as defined by the commissioner of health. In all
33 school districts, such physician, physician assistant or nurse practi-
34 tioner shall determine whether a one-time test for sickle cell anemia is
35 necessary or desirable and he or she shall conduct such tests and the
36 certificate shall state the results. If it should be ascertained, upon
37 such test or examination, that any of such students have defective sight
38 or hearing, or other physical disability, including sickle cell anemia,
39 as above described, the principal or his or her designee shall notify
40 the parents of, or other persons in parental relation to, the child as
41 to the existence of such disability. If the parents or other persons in
42 parental relation are unable or unwilling to provide the necessary
43 relief and treatment for such students, such fact shall be reported by
44 the principal or his or her designee to the director of school health
45 services, whose duty it shall be to provide relief for such students.
46 Each school and school district chosen as part of an appropriate sampl-
47 ing methodology shall participate in surveys directed by the commission-
48 er of health pursuant to the public health law in relation to students'
49 BMI and weight status categories as determined by the examination
50 conducted pursuant to this section and which shall be subject to audit
51 by the commissioner of health. Such surveys shall contain the informa-
52 tion required pursuant to this subdivision in relation to students' BMI
53 and weight status categories in aggregate. Parents or other persons in
54 parental relation to a student may refuse to have the student's BMI and
55 weight status category included in such survey. Each school and school
56 district shall provide the commissioner of health with any information,
S. 2108--C 109 A. 4308--C
1 records and reports he or she may require for the purpose of such audit.
2 The BMI and weight status survey and audit as described in this section
3 shall be conducted consistent with confidentiality requirements imposed
4 by federal law. Data collection for such surveys shall commence on a
5 voluntary basis at the beginning of the two thousand seven academic
6 school year, and by all schools chosen as part of the sampling methodol-
7 ogy at the beginning of the two thousand eight academic school year. The
8 department shall also utilize the collected data to develop a report of
9 child obesity and obesity related diseases.
10 § 13. Intentionally omitted.
11 § 14. Section 4 of chapter 198 of the laws of 1978, relating to
12 authorizing projects to provide improved and expanded school health
13 services for pre-school and school-age children, as amended by chapter
14 34 of the laws of 2005, is amended to read as follows:
15 § 4. Projects authorized by this act shall operate for a period of not
16 less than one and not more than [twenty-nine] thirty-three years.
17 § 15. The state finance law is amended by adding a new section 97-gggg
18 to read as follows:
19 § 97-gggg. Medicaid training contract account. 1. There is hereby
20 established in the joint custody of the state comptroller and the
21 commissioner of taxation and finance an account of the miscellaneous
22 special revenue fund to be known as the "medicaid training contract
23 account".
24 2. Such account shall consist of monies received from a contract
25 management fee resulting from contracts relating to training of local
26 social services district and state staff for the medical assistance
27 program.
28 3. Moneys of this account, following appropriation by the legislature,
29 shall be available to the department of health for administrative activ-
30 ities related to the development and management of training contracts.
31 § 16. Section 276-a of the public health law, as added by chapter 293
32 of the laws of 2005, is amended to read as follows:
33 § 276-a. Prescription drug retail price lists. 1. The department shall
34 make prescription drug retail price lists of pharmacies, with the name
35 and address of each pharmacy, available to the public in a database on
36 its website at all times. The website shall enable consumers to search
37 the database for drug retail prices of pharmacies selected by zip code
38 of the pharmacy and other appropriate factors, including enabling
39 consumers to display and compare prices for one or more selected drugs
40 as well as for the full list. The website shall enable consumers to
41 download and print displayed information. The website shall accommodate
42 reasonably anticipated and actual public use of the database. The data-
43 base shall display drug retail prices for the compendium of the one
44 hundred fifty most frequently prescribed drugs received by the depart-
45 ment from the department of education under section sixty-eight hundred
46 twenty-six of the education law.
47 2. The department shall extract pharmacy retail price information,
48 showing the actual price to be paid to the pharmacy by a retail purchas-
49 er for any listed drug at the listed dosage, from usual and customary
50 price data collected by the medical assistance program under title elev-
51 en of article five of the social services law. Provided, however, that
52 any pharmacy participating in the medical assistance program shall
53 provide the usual and customary price data for the one hundred fifty
54 most frequently prescribed drugs under section sixty-eight hundred twen-
55 ty-six of the education law to the department through the same mechanism
56 that the usual and customary price data is received under the medical
S. 2108--C 110 A. 4308--C
1 assistance program. If the department is unable to process such data,
2 the pharmacy shall fax or electronically transmit to the department the
3 usual and customary price data for the one hundred fifty most frequently
4 prescribed drugs under section sixty-eight hundred twenty-six of the
5 education law. The prescription drug retail price list database shall be
6 subject to and conform with applicable state and federal requirements,
7 including those concerning privacy, confidentiality and use of informa-
8 tion. The commissioner shall seek a waiver of any federal requirement
9 necessary for development and implementation of the database under this
10 section. Upon implementation of this system, this section shall apply
11 in place of any inconsistent provision of section sixty-eight hundred
12 twenty-six of the education law. The prescription drug retail price list
13 database on the department's website shall list a pharmacy's price
14 information extracted under this subdivision as the pharmacy's retail
15 price for each drug. The department shall update the prescription drug
16 retail price list at least weekly using the most recent retail price for
17 each drug for each pharmacy as reasonably practicable.
18 2-a. Pharmacies which do not provide usual and customary price data in
19 the manner specified in subdivision two of this section shall transmit
20 the drug retail price list compiled pursuant to section sixty-eight
21 hundred twenty-six of the education law to the department in a manner
22 and frequency prescribed by the department and the department shall
23 extract the usual and customary price data information from such drug
24 retail price list; provided that the commissioner may exempt any catego-
25 ry of pharmacy not required to compile such list pursuant to section
26 sixty-eight hundred twenty-six of the education law.
27 3. [Whenever the pharmacy retail price list is updated, the department
28 shall electronically transmit to each pharmacy the data on the list
29 applicable to that pharmacy. The pharmacy shall use that data to create
30 the list it provides to persons under section sixty-eight hundred twen-
31 ty-six of the education law.
32 4.] The prescription drug retail price list database on the depart-
33 ment's website shall contain an advisory statement by the department
34 alerting consumers of the need to tell their health care practitioner
35 and pharmacist about all the medications they may be taking and to ask
36 them how to avoid harmful interactions between the drugs, if any. A
37 pharmacy may submit to the department a brief statement, acceptable to
38 the department, to be included on the website in conjunction with the
39 pharmacy's prescription drug retail price information: (a) concerning
40 discounts from its listed retail prices that may be available to consum-
41 ers and (b) any limitations that the pharmacy may have as to what group
42 or groups of customers it serves.
43 [5.] 4. In developing and implementing the prescription drug retail
44 price list database system, the department may seek and shall receive
45 the assistance of the departments of education and law.
46 [6.] 5. The commissioner shall provide an interim progress report
47 concerning efforts to develop and implement the database system under
48 this section not later than January thirty-first, two thousand six. The
49 report shall include a projected completion date, a description of
50 obstacles to development and implementation of the database system, and
51 an estimate of the costs to complete the implementation of the database
52 system.
53 [7.] 6. As used in this section, "pharmacy" means any place in which
54 drugs or prescriptions are possessed for the purpose of retailing, or in
55 which drugs or prescriptions are retailed, or in which drugs or
S. 2108--C 111 A. 4308--C
1 prescriptions are by advertising or otherwise offered for sale at
2 retail.
3 § 17. Subdivision 1 of section 6826 of the education law, as amended
4 by chapter 284 of the laws of 2002, is amended to read as follows:
5 1. Every pharmacy shall compile a drug retail price list, which shall
6 contain the names of the drugs on the list provided by the board [and],
7 the pharmacy's corresponding retail prices for each drug. Every pharmacy
8 shall update its drug retail list at least weekly and provide the time
9 and date that the list was updated. Every pharmacy shall provide the
10 drug retail price list to any person upon request.
11 § 18. Section 203 of the elder law is amended by adding a new subdivi-
12 sion 8 to read as follows:
13 8. The director, in consultation with the commissioner of health,
14 shall establish a program to be known as the NY Connects: Choices for
15 Long Term Care. The purpose of this initiative is to provide consistent,
16 comprehensive, locally-based information and assistance on long term
17 care services to consumers, caregivers and families to help them make
18 educated choices. This program shall provide individuals, caregivers,
19 and families with objective information and assistance about home,
20 community-based and institutional long term care services. NY Connects
21 will be available on a voluntary basis to consumers, caregivers and
22 their families. There shall be an on-going education and outreach
23 campaign to educate the public about long term care services available
24 in their community and to assist consumers in preparing for their long
25 term care needs.
26 § 19. Residential Health Care facilities which are architecturally
27 separate homes caring for no more than twelve residents per home.
28 1. The department of health, in conjunction with the office for the
29 aging, shall study residential health care facilities which consist of
30 one or more architecturally separate homes each designed to care for
31 approximately twelve residents per home. The study shall focus on effi-
32 cacy, quality of care, and methodologies for reimbursement of capital
33 and operating costs.
34 2. Notwithstanding subdivision one of this section, on a demonstration
35 basis, without requirement for a request for proposals, the department
36 may adjust the medicaid nursing home capital reimbursement cap in order
37 to effectuate the construction of a residential health care facility
38 described in subdivision one of this section, by the Capital Region
39 Rehabilitation Center also known as the Eddy Cohoes Rehabilitation
40 Center.
41 3. Upon completion and occupation of the first residential unit of a
42 facility under this demonstration and annually thereafter, the Capital
43 Region Rehabilitation Center also known as the Eddy Cohoes Rehabili-
44 tation Center shall report to the department on the number of patients
45 served, the type of services provided, and outcome and financial data
46 that demonstrates the efficacy of this residential model.
47 § 20. Subdivision 3 of section 461-1 of the social services law is
48 amended by adding a new paragraph (h) to read as follows:
49 (h) The commissioner is authorized to add one thousand five hundred
50 assisted living program beds to the gross number of assisted living
51 program beds having been determined to be available as of April first,
52 two thousand seven.
53 § 21. The social services law is amended by adding a new section 461-r
54 to read as follows:
55 § 461-r. Food services. 1. Food services in adult care facilities
56 shall be provided in a manner that respects the dietary needs of the
S. 2108--C 112 A. 4308--C
1 residents in relation to health conditions, food allergies and dietary
2 intolerances, religious and ethnic mandates, and that allows for a
3 reasonable variation in taste preferences.
4 2. Resident food committees in each facility, assembled from among the
5 residents, shall have the freedom to meet and evaluate the food service
6 available to them without interference, and shall advise the operators
7 of the adult care facility as to issues of dietary needs, preferences,
8 food quality and safety.
9 3. The commissioner of health shall review existing adult care facili-
10 ty regulations and amend existing regulations or promulgate new regu-
11 lations if appropriate, to determine those food service personnel in
12 adult care facilities that should undergo training appropriate for the
13 level of food service which they may perform, including but not limited
14 to sanitation in the food preparation and service areas; refrigeration
15 and preservation; principles of a balanced meal; and ordering with an
16 emphasis on fresh foods.
17 § 22. The public health law is amended by adding a new article 27-K to
18 read as follows:
19 ARTICLE 27-K
20 NEW YORK WELLNESS WORKS
21 Section 2799-o. New York wellness works; program established.
22 2799-p. Advisory panel.
23 2799-q. Participation in New York wellness works.
24 2799-r. Program evaluations and recommendations; reports and
25 statewide conference on best practices.
26 § 2799-o. New York wellness works; program established. 1. The New
27 York wellness works program is hereby established as a partnership
28 between the state and employers to encourage health screening, education
29 and incentives tailored to employees' specific needs to help promote
30 health and prevent disease.
31 2. Upon the commissioner's approval, and within the amount appropri-
32 ated, the department shall make available grants for the purpose of
33 enabling employers to develop and implement health promotion and disease
34 prevention initiatives. Such initiatives may include, but shall not be
35 limited to:
36 (a) the compilation of individual or aggregate employee health
37 profiles, on an individual voluntary basis, with recommendations and
38 incentives for health promotion activities based on individual or aggre-
39 gate health information; or
40 (b) specific screening, education and health incentives; or
41 (c) such other employer-based health promotion and disease prevention
42 measures, including changes to the work environment and policy changes
43 in the worksite, as the commissioner may approve in accordance with this
44 article.
45 3. The department may contract with an organization or organizations
46 for the administration of the program, in accordance with the criteria
47 for participation in said program as set forth in section two thousand
48 seven hundred ninety-nine-q of this article.
49 4. In addition to any amounts as may be appropriated for grants, the
50 commissioner is authorized to seek and receive funds from philanthropic
51 foundations and other sources to further support such purposes.
52 § 2799-p. Advisory panel. The commissioner shall convene and consult
53 with an advisory panel comprised of representatives of the school of
54 public health and health professions at the university at Buffalo, busi-
55 ness, employees, physicians, and other health care providers and others
56 with expertise in workplace health and wellness to provide guidance in
S. 2108--C 113 A. 4308--C
1 implementing the New York wellness works program. Members of the advi-
2 sory panel shall serve without compensation.
3 § 2799-q. Participation in New York wellness works. The commissioner,
4 in consultation with the advisory panel, shall establish criteria for
5 implementation and operation of the New York wellness works program,
6 which at a minimum shall include:
7 (a) applicant eligibility and selection criteria;
8 (b) program operating requirements and standards;
9 (c) employee safeguards.
10 § 2799-r. Program evaluations and recommendations; reports and state-
11 wide conference on best practices. 1. Employers participating in the
12 New York wellness works program pursuant to this article shall report to
13 the commissioner on the findings, experience and benefits pursuant to
14 such program.
15 2. The commissioner shall evaluate and report his or her findings
16 concerning the New York wellness works program, including but not limit-
17 ed to the health and cost benefits, and shall make recommendations for
18 modifying, expanding or otherwise improving the program as well as
19 recommendations for other health system improvements based on such
20 program. Such report shall incorporate the information submitted pursu-
21 ant to subdivision one of this section and shall be submitted to the
22 governor, temporary president of the senate, speaker of the assembly and
23 the school of public health and health professions at the university at
24 Buffalo on or before February first, two thousand nine.
25 On or before May first, two thousand nine, and at least biennially
26 thereafter, the commissioner in consultation with the advisory panel
27 shall convene a statewide conference to further promote the sharing of
28 best practices among employers and others in pursuit of the goals of the
29 New York wellness works program.
30 § 23. Section 1370-a of the public health law is amended by adding a
31 new subdivision 3 to read as follows:
32 3. The department shall identify and designate a zip code in certain
33 counties with significant concentrations of children identified with
34 elevated blood lead levels for purposes of implementing a pilot program
35 to work in cooperation with local health officials to develop a primary
36 prevention plan for each such zip code identified to prevent exposure to
37 lead-based paint. The commissioner is authorized to enter into agree-
38 ments or memoranda of understanding with, and provide technical and
39 other resources to, local health officials, local building code offi-
40 cials, real property owners, and community organizations in such areas
41 to create and implement policies, education and other forms of community
42 outreach to address lead exposure, detection and risk reduction. Such
43 primary prevention plans shall target children less than six years of
44 age living in the highest risk housing in the zip code identified. Such
45 primary prevention plans shall also take into consideration the extent
46 the weatherization assistance or other such programs can be used in
47 collaboration with lead-based paint hazard risk reduction.
48 § 24. The public health law is amended by adding a new section 2004-a
49 to read as follows:
50 § 2004-a. Coordinating council for services related to Alzheimer's
51 disease and other dementia. 1. There is hereby created in the depart-
52 ment of health a coordinating council for services related to
53 Alzheimer's disease and other dementia, to facilitate interagency plan-
54 ning and policy, review specific agency initiatives for their impact on
55 services related to the care of persons with dementia and their fami-
56 lies, and provide a continuing forum for concerns and discussion
S. 2108--C 114 A. 4308--C
1 related to the formulation of a comprehensive state policy relating to
2 Alzheimer's disease and services for persons with incurable dementia.
3 2. The council shall be comprised of twenty-one members as follows:
4 the commissioner of health, the director of the state office for the
5 aging, the commissioner of children and family services, the commission-
6 er of education, the commissioner of mental health and the commissioner
7 of mental retardation and developmental disabilities who shall serve ex
8 officio and who may designate representatives to act on their behalf.
9 The governor shall appoint seven other members with expertise in
10 Alzheimer's disease, other dementia or elder care issues, at least two
11 of whom shall represent not-for-profit corporations whose primary
12 purpose is to provide access to experts in the care of persons with
13 Alzheimer's disease and related dementia, that are part of a statewide
14 network of not-for-profit corporations established specifically to
15 respond at the local and regional level to the needs of this population
16 and that provide family intervention services related to Alzheimer's
17 disease in order to postpone or prevent nursing home placements of
18 individuals with Alzheimer's disease or other dementia. Eight members
19 shall be appointed by the governor on the recommendation of the legisla-
20 tive leaders as follows: the temporary president of the senate and the
21 speaker of the assembly shall each recommend three members to the coun-
22 cil. One of the three members recommended by the temporary president
23 and one of the three members recommended by the speaker shall be a
24 clinical or research expert in the field of dementia and one of the
25 three members appointed by each shall be a family member or caregiver of
26 a person suffering from Alzheimer's disease or other dementia. One
27 member shall be appointed on the recommendation of the minority leader
28 of the senate and one member shall be appointed on the recommendation of
29 the minority leader of the assembly. The commissioner of health and
30 the director of the office for the aging shall serve, ex officio, as
31 co-chairs of the council. Administrative duties shall be the responsi-
32 bility of the department. The members of the council shall receive no
33 compensation for their services.
34 3. Within one year after the effective date of this section, the
35 council shall establish community forums to gain input from consumers,
36 providers, key researchers in the field and other interested parties to
37 provide input and direction on developing a New York state plan for the
38 identification and treatment of Alzheimer's disease in the community. A
39 community forum shall be established in each of the following regions of
40 the state: Long Island, New York city, Northern Metropolitan New York,
41 Northeastern New York, Utica area, Central New York, Rochester area and
42 Western New York. Such state plan shall include but not be limited to
43 identifying best practices in working with persons with Alzheimer's
44 disease, best interventions for caregivers to help reduce caregiver
45 burnout, best approaches to training doctors, nurses and other medical
46 and non-medical professionals and paraprofessionals to identify
47 Alzheimer's disease, a community assessment of strengths and gaps in
48 community support services, ways in which to coordinate services among
49 various systems, different financing approaches to pay for community
50 support services and any other recommendations.
51 4. The council shall meet quarterly or more frequently if its business
52 shall require. The community forums in the first year of implementation
53 count as a formal meeting of the council. The state shall not be respon-
54 sible for cost, travel, and other incidental or contingent expenses of
55 council members. The council shall provide reports to the governor and
56 the legislature on or before June thirtieth, two thousand nine and by
S. 2108--C 115 A. 4308--C
1 June thirtieth of every other year thereafter. Such reports shall
2 include recommendations for state policy relating to dementia and a
3 review of services initiated and coordinated among public and private
4 agencies to meet the needs of persons with Alzheimer's disease and
5 other dementia and their families.
6 5. The department shall serve as the focal point to develop comprehen-
7 sive coordinated responses of the various state agencies with regard to
8 Alzheimer's disease and related dementia and thus help to assure timely
9 and appropriate responses to issues and problems. The department shall
10 collaborate with the state office for the aging on issues related to
11 nonmedical support services for individuals with Alzheimer's disease and
12 other dementia and their caregivers. The department shall collaborate
13 with other appropriate state agencies to establish a simplified coordi-
14 nated assessment procedure for obtaining needed services for persons
15 with Alzheimer's disease and other dementia.
16 6. The department, in consultation with the council, shall utilize
17 data and information compiled and maintained pursuant to this article
18 to coordinate state funded research efforts to ensure the most efficient
19 use of funds available for this purpose.
20 § 24-a. Subdivision 6 of section 214 of the elder law is amended to
21 read as follows:
22 6. Implementation of home care plans. Within the amounts appropriated
23 therefor, counties authorized to provide expanded non-medical in-home
24 services, non-institutional respite services, case management services,
25 and ancillary services pursuant to paragraph (i) of subdivision four of
26 this section shall be eligible for reimbursement by the state of one
27 hundred percent of allowable expenditures for implementing the approved
28 county home care plan for functionally impaired elderly, limited to a
29 sum equivalent to [one-half] the amount available to such county pursu-
30 ant to subparagraph one of paragraph (a) of subdivision four of this
31 section.
32 § 24-b. The commissioner of health shall annually, on or before March
33 31, report to the legislature and the governor on the performance
34 outcomes of each program, under the department of health's purview, that
35 promote child health and wellness. These programs include, but are not
36 limited to: Active8Kids; the Healthy Heart program; Steps to a Healthier
37 New York; and, Eat Well Play Hard. The report shall include but not be
38 limited to: the goals of each program; interrelationship between such
39 programs; achievements made toward reaching the goals of each program;
40 the types of materials disseminated relating to the program; and, future
41 goals of the program.
42 § 24-c. The elder law is amended by adding a new article III to read
43 as follows:
44 ARTICLE III
45 MATURE WORKER INITIATIVES
46 Section 301. Mature worker task force.
47 § 301. Mature worker task force. 1. For the purposes of this article,
48 the term "task force" shall mean the mature worker task force estab-
49 lished by this section.
50 2. (a) There is hereby established within the office a mature worker
51 task force. The purpose of the task force shall be to coordinate the
52 state's efforts to assist older persons who choose to work and remain
53 self-sufficient throughout their lives, or who choose to work after
54 retirement; to support business growth and development across the state
55 in light of increasing aging workforce; and to combat ageism and stere-
56 otypes.
S. 2108--C 116 A. 4308--C
1 (b) The task force shall be composed of nineteen members as follows:
2 (1) Seven ex-officio members as follows:
3 (i) the director, who shall serve as co-chair of the task force;
4 (ii) the commissioner of labor, who shall serve as co-chair of the
5 task force;
6 (iii) the commissioner of education;
7 (iv) the commissioner of mental health;
8 (v) the president of the state civil service commission;
9 (vi) the chairman of the Urban Development Corporation; and
10 (vii) the commissioner of the department of economic development.
11 Any ex-officio member may designate a representative to act on his or
12 her behalf;
13 (2) Two members appointed by the governor, who shall be represen-
14 tatives of not-for-profit corporations the primary purposes of which are
15 to provide employment services to older persons and specifically serve
16 them in their efforts to develop the requisite skills for an ever chang-
17 ing job market;
18 (3) Two members appointed by the governor, who shall be represen-
19 tatives of organizations representing business interests;
20 (4) Three members appointed by the governor upon the nomination of the
21 temporary president of the senate, of whom one shall be a representative
22 of organized labor, one shall be a research expert in the field of older
23 worker employment issues and one shall be a mature worker;
24 (5) Three members appointed by the governor upon the nomination of the
25 speaker of the assembly, of whom one shall be a representative of organ-
26 ized labor, one shall be a research expert in the field of older worker
27 employment issues and one shall be a mature worker;
28 (6) One member appointed by the governor upon the nomination of the
29 minority leader of the senate; and
30 (7) One member appointed by the governor upon the nomination of the
31 minority leader of the assembly.
32 (c) The administrative support of the task force shall be equally
33 provided by the office and the department of labor.
34 3. Powers and duties. The task force shall have the following powers
35 and duties:
36 (a) to facilitate interagency planning and policy, review specific
37 agency initiatives for their impact on mature workers and businesses,
38 provide a continuing forum to discuss concerns and issues related to the
39 formulation of state policy designed to help address this policy area,
40 and develop linkages and partnerships with businesses and other appro-
41 priate entities to assist such businesses in identifying and helping
42 them to fill their workforce needs;
43 (b) to identify existing statutory and regulatory provisions and busi-
44 ness practices that limit opportunities for mature workers and develop
45 legislative and regulatory proposals to address such limitations;
46 (c) to identify best practices in the private sector for hiring,
47 retaining and retraining mature workers, and serve as a clearing house
48 of such information;
49 (d) to assess the effectiveness and costs of programs that state agen-
50 cies have implemented to hire, retain and retrain mature workers, and
51 recommend cost-effective programs for all state agencies to hire, retain
52 and retrain older workers;
53 (e) to meet quarterly or more frequently if its business shall
54 require;
55 (f) to develop recommendations and proposals for a mature worker
56 employment training program and a mature worker business initiative;
S. 2108--C 117 A. 4308--C
1 (g) to annually report to the governor and the legislature on or
2 before June thirtieth, commencing in two thousand eight, its recommenda-
3 tions for state policy relating to mature workers, best practices in the
4 business sector for hiring, retaining and retraining mature workers, and
5 a review of services initiated and coordinated among public and private
6 agencies that meet the needs of older workers who are seeking to remain
7 active in the workforce. The report required by this subdivision shall
8 be posted on the office's internet website; and
9 (h) to serve as the focal point for the development of coordinated
10 responses by the various state agencies with regard to issues of impor-
11 tance to mature workers to ensure timely and appropriate responses to
12 issues and problems.
13 4. Implementation. (a) The office shall collaborate with the depart-
14 ment of labor on issues related to the development of mature worker
15 support initiatives and enhancing access by mature workers to existing
16 training and employment services funded through federal and state
17 resources.
18 (b) The office shall utilize the data and information compiled and
19 maintained by the task force to coordinate state funded research and
20 employment training efforts to ensure the most efficient use of funds
21 available for such purposes.
22 § 24-d. Subdivisions 11, 12 and 13 of section 202 of the elder law are
23 amended and a new subdivision 14 is added to read as follows:
24 11. to enter into contracts, within the amount available by appropri-
25 ation therefor, with individuals, organizations and institutions, in the
26 exercise of any of its powers or the performance of any of its
27 duties[.];
28 12. to make recommendations to the governor for the presentation of an
29 annual award to a senior citizen for outstanding and unusual contrib-
30 ution to his or her community[.];
31 13. to conduct a program of education and information on age discrimi-
32 nation and the preparation and filing of complaints relating to persons
33 sixty years of age or older[.]; and
34 14. to, in cooperation with the department of state:
35 (a) prepare or cause to be prepared and made available to cities,
36 towns and villages model zoning and planning guidelines that foster
37 age-integrated communities including mixed-use age-integrated communi-
38 ties; and
39 (b) make recommendations, in consultation with the division of housing
40 and community renewal, to the governor and legislature for assisting
41 mixed-use age-integrated housing development or redevelopment demon-
42 stration projects in urban, suburban and rural areas of the state. The
43 director of the office for the aging and secretary of state shall estab-
44 lish an advisory committee for purposes of this subdivision. Such
45 committee shall include, but not be limited to, top representatives of
46 local government, senior citizen organizations, developers, senior
47 service providers and planners.
48 § 24-e. The commissioner of health, in consultation with the assisted
49 living reform act task force, the chair of the commission on quality of
50 care for the mentally disabled, the commissioner of mental health, the
51 commissioner of the office of temporary and disability assistance, the
52 director of the office for the aging, and experts, shall undertake a
53 study to evaluate the adequacy of and accountability for supplemental
54 security income, medical assistance and safety net assistance payments
55 made to adult care facilities and to or on behalf of the residents of
56 adult care facilities. The study shall determine and recommend rates and
S. 2108--C 118 A. 4308--C
1 models of compensation for adult care facilities sufficient to assure
2 the health and safety of adult care facility residents, adequate
3 personal needs and clothing allowances for residents of adult care
4 facilities, and evaluate the merits of alternative financial and service
5 models for adult care facilities. The study shall include recommenda-
6 tions concerning how supplemental security income and medical assistance
7 financing should be structured with respect to the services provided
8 within adult care facilities by operators and outside medical assistance
9 providers. The commissioner shall publish the study and provide copies
10 to the governor, the temporary president of the senate, the speaker of
11 the assembly and the minority leaders of the senate and assembly not
12 later than January 1, 2008.
13 § 25. This act shall take effect immediately and shall be deemed to
14 have been in full force and effect on and after April 1, 2007; provided,
15 however, that sections one, two and three of this act shall take effect
16 July 1, 2007; provided, however, that section twenty-four of this act
17 shall take effect November 1, 2007; provided, however, that the amend-
18 ments to subdivision 3381 of the public health law made by section
19 nine-a of this act shall not affect the repeal of such section and shall
20 be deemed repealed therewith; and sections sixteen, seventeen and twen-
21 ty-four-c of this act shall take effect on the one hundred eightieth day
22 after such sections shall have become law. Provided, that, effective
23 immediately, any rules and regulations necessary to implement the
24 provisions of section twenty-four-c of this act on its effective date
25 are authorized to be completed on or before such date.
26 PART C
27 Section 1. Subdivision 5 of section 366-a of the social services law
28 is amended by adding two new paragraphs (d) and (e) to read as follows:
29 (d) In order to establish place of residence and income eligibility
30 under this title at recertification, a recipient of assistance under
31 this title shall attest to place of residence and to all information
32 regarding the household's income that is necessary and sufficient to
33 determine such eligibility; provided, however, that this paragraph shall
34 not apply to persons described in subparagraph two of paragraph (a) of
35 subdivision one of section three hundred sixty-six of this title, or to
36 persons receiving long term care services, as defined in paragraph (b)
37 of subdivision two of this section.
38 (e) The commissioner of health shall verify the accuracy of the infor-
39 mation provided by the recipient pursuant to paragraph (d) of this
40 subdivision by matching it against information to which the commissioner
41 of health has access, including under subdivision eight of this section.
42 In the event there is an inconsistency between the information reported
43 by the recipient and any information obtained by the commissioner of
44 health from other sources and such inconsistency is material to medical
45 assistance eligibility, the commissioner of health shall request that
46 the recipient provide adequate documentation to verify his or her place
47 of residence or income, as applicable. In addition to the documentation
48 of residence and income authorized by this paragraph, the commissioner
49 of health is authorized to periodically require a reasonable sample of
50 recipients to provide documentation of residence and income at recertif-
51 ication. The commissioner of health shall consult with the medicaid
52 inspector general regarding income and residence verification practices
53 and procedures necessary to maintain program integrity and deter fraud
54 and abuse.
S. 2108--C 119 A. 4308--C
1 § 1-a. Subdivision 8 of section 366-a of the social services law, as
2 added by chapter 304 of the laws of 1990, is amended to read as follows:
3 8. Notwithstanding [subdivision] subdivisions two and five of this
4 section, information concerning income and resources of applicants for
5 and recipients of medical assistance may be verified by matching client
6 information with information contained in the wage reporting system
7 established by section one hundred seventy-one-a of the tax law and[,]
8 with similar systems operating in other geographically contiguous
9 states, and, to the extent required by federal law, with the non-wage
10 income file maintained by the United States internal revenue service,
11 with the beneficiary data exchange maintained by the United States
12 department of health and human services, and with the unemployment
13 insurance benefits file. Such matching shall provide for procedures
14 which document significant inconsistent results of matching activities.
15 Nothing in this section shall be construed to prohibit activities the
16 department reasonably believes necessary to conform with federal
17 requirements under section one thousand one hundred thirty-seven of the
18 social security act.
19 § 1-b. Subdivision 4 of section 366 of the social services law is
20 amended by adding a new paragraph (x) to read as follows:
21 (x) Notwithstanding any other provision of law, a person who is eligi-
22 ble for medical assistance pursuant to subparagraph one, four, five,
23 seven, eight, nine or ten of paragraph (a) of subdivision one of this
24 section, but who loses eligibility for such assistance for any reason
25 other than loss of state residence before the end of a twelve month
26 period beginning on the effective date of the person's initial eligibil-
27 ity for such assistance, or before the end of a twelve month period
28 beginning on the date of any subsequent determination of eligibility,
29 shall have his or her eligibility for such assistance continued until
30 the end of such twelve month period; provided that federal financial
31 participation in the costs of such assistance is available; and provided
32 further that a person who is otherwise described in this paragraph but
33 who is eligible for federal supplemental security income benefits and/or
34 additional state payments, or whose net income, without deducting the
35 amount of any incurred medical expenses, exceeds the net income
36 exemptions set forth in subparagraph seven of paragraph (a) of subdivi-
37 sion two of this section, is not eligible for the twelve month contin-
38 uous coverage described in this paragraph.
39 § 1-c. Subdivision 2 of section 369-ee of the social services law is
40 amended by adding a new paragraph (d) to read as follows:
41 (d) In order to establish place of residence and income eligibility
42 under this title at recertification, a recipient of assistance under
43 this title shall attest to place of residence and to all information
44 regarding the household's income that is necessary and sufficient to
45 determine such eligibility. The commissioner of health shall verify the
46 accuracy of the information provided by the recipient pursuant to this
47 paragraph by matching it against information to which the commissioner
48 of health has access, including under subdivision eight of section three
49 hundred sixty-six-a of this article. In the event there is an incon-
50 sistency between the information reported by the recipient and any
51 information obtained by the commissioner of health from other sources
52 and such inconsistency is material to eligibility under this title, the
53 commissioner of health shall request that the recipient provide adequate
54 documentation to verify his or her place of residence or income, as
55 applicable. In addition to the documentation of residence and income
56 authorized by this paragraph, the commissioner of health is authorized
S. 2108--C 120 A. 4308--C
1 to periodically require a reasonable sample of recipients to provide
2 documentation of residence and income at recertification. The commis-
3 sioner of health shall consult with the medicaid inspector general
4 regarding income and residence verification practices and procedures
5 necessary to maintain program integrity and deter fraud and abuse.
6 § 1-d. Paragraph (b) of subdivision 2 of section 369-ee of the social
7 services law, as amended by section 4 of part B of chapter 58 of the
8 laws of 2004, is amended to read as follows:
9 (b) [In] Subject to the provisions of paragraph (d) of this subdivi-
10 sion, in order to establish income eligibility under this subdivision,
11 an individual shall provide such documentation as is necessary and
12 sufficient to initially, and annually thereafter, determine an appli-
13 cant's eligibility for coverage under this title. Such documentation
14 shall include, but not be limited to the following, if needed to verify
15 eligibility:
16 (i) paycheck stubs; or
17 (ii) written documentation of income from all employers; or
18 (iii) other documentation of income (earned or unearned) as determined
19 by the commissioner, provided however, such documentation shall set
20 forth the source of such income; and
21 (iv) proof of identity and residence as determined by the commission-
22 er.
23 § 1-e. Paragraph (c) of subdivision 3 of section 369-ee of the social
24 services law, as added by chapter 1 of the laws of 1999, is amended to
25 read as follows:
26 (c) Participants under this section who have lost their eligibility
27 for health care services before the end of a [six] twelve month period
28 beginning on the date of the participant's initial enrollment in a fami-
29 ly health insurance plan, or before the end of a twelve month period
30 beginning on the date of any subsequent determination of eligibility,
31 shall have their eligibility for family health plus continued until the
32 end of the [six] twelve month [enrollment] period, provided that federal
33 financial participation in the cost of such coverage is available; and
34 provided further that such participants who cease to be eligible because
35 they no longer reside in New York state, or who have access to or have
36 obtained other health insurance coverage, as defined by the commissioner
37 in consultation with the superintendent of insurance, shall not be
38 eligible for the extended enrollment described in this paragraph.
39 § 1-f. Paragraph (w) of subdivision 4 of section 366 of the social
40 services law, as added by chapter 16 of the laws of 2002, is amended to
41 read as follows:
42 (w) A woman who was pregnant while in receipt of medical assistance
43 who subsequently loses her eligibility for medical assistance shall have
44 her eligibility for medical assistance continued for a period of twen-
45 ty-four months from the end of the month in which the sixtieth day
46 following the end of her pregnancy occurs but only for Federal Title X
47 services which [shall continue for twenty-four months therefrom, and
48 provided further that the services are reimbursable] are eligible for
49 reimbursement by the federal government at a rate of ninety percent;
50 provided, however, that such ninety percent limitation shall not apply
51 to those services identified by the commissioner as services, including
52 treatment for sexually transmitted diseases, generally performed as part
53 of or as a follow-up to a service eligible for such ninety percent
54 reimbursement; and provided further, however, that nothing in this para-
55 graph shall be deemed to affect payment for such Title X services if
56 federal financial participation is not available for such care, services
S. 2108--C 121 A. 4308--C
1 and supplies [solely by reason of the immigration status of the other-
2 wise eligible woman].
3 § 1-g. Subdivision 11 of section 364-j of the social services law, as
4 added by chapter 16 of the laws of 2002, is amended to read as follows:
5 11. Notwithstanding section three hundred sixty-six of this chapter or
6 any other inconsistent provision of law, participants in the managed
7 care program under this section who have lost their eligibility for
8 medical assistance before the end of a six month period beginning on the
9 date of the participant's initial selection of or assignment to a
10 managed care provider shall have their eligibility for medical assist-
11 ance continued until the end of the six month enrollment period, but
12 only with respect to family planning services provided pursuant to
13 subparagraph (iii) of paragraph (a) of subdivision four of this section
14 and any services provided to the individual under the direction of the
15 managed care provider. Provided further, however, a pregnant woman with
16 an income in excess of the medically needy income level set forth in
17 section three hundred sixty-six of this title, who was eligible for
18 medical assistance solely as a result of paragraph (m) or (o) of subdi-
19 vision four of such section, shall continue to be eligible for medical
20 assistance benefits only through the end of the month in which the
21 sixtieth day following the end of her pregnancy occurs except for eligi-
22 bility for Federal Title X services which are eligible for reimbursement
23 by the federal government at a rate of ninety percent which shall
24 continue for twenty-four months therefrom[, and provided further that
25 the services are reimbursable by the federal government at a rate of
26 ninety percent]; provided, however, that such ninety percent limitation
27 shall not apply to those services identified by the commissioner as
28 services, including treatment for sexually transmitted diseases, gener-
29 ally performed as part of or as a follow-up to a service eligible for
30 such ninety percent reimbursement; and provided further, however, that
31 nothing in this subdivision shall be deemed to affect payment for such
32 Title X services if federal financial participation is not available for
33 such care, services and supplies [solely by reason of the immigration
34 status of the otherwise eligible woman].
35 § 1-h. Subparagraph 11 of paragraph (a) of subdivision 1 of section
36 366 of the social services law, as amended by section 61 of part A of
37 chapter 1 of the laws of 2002, is amended to read as follows:
38 (11) for purposes of receiving family planning services eligible for
39 reimbursement by the federal government at a rate of ninety percent, is
40 not otherwise eligible for medical assistance and whose income is two
41 hundred percent or less of the comparable federal income official pover-
42 ty line (as defined and annually revised by the United States department
43 of health and human services); provided, however, that such ninety
44 percent limitation shall not apply to those services identified by the
45 commissioner of health as services, including treatment for sexually
46 transmitted diseases, generally performed as part of or as a follow-up
47 to a service eligible for such ninety percent reimbursement. The
48 commissioner of health shall submit whatever waiver applications as may
49 be necessary to receive federal financial participation for services
50 provided under this subparagraph and the provisions of this subparagraph
51 shall be effective if and so long as such federal financial partic-
52 ipation shall be available; or
53 § 2. The social services law is amended by adding a new section 364-l
54 to read as follows:
55 § 364-l. Chronic illness demonstration projects. 1. The legislature
56 finds that medicaid beneficiaries with multiple co-morbidities are among
S. 2108--C 122 A. 4308--C
1 the most medically complicated and most costly, accounting for twenty
2 percent of all medicaid beneficiaries, but seventy-five percent of all
3 medicaid costs. Because these individuals require services across multi-
4 ple delivery systems, licensed by multiple agencies, their care is often
5 fragmented, uncoordinated and at times duplicative. The legislature
6 further finds that through targeted interventions the care of these
7 individuals can be improved and the costs of that care reduced.
8 2. To the extent of funds appropriated for this purpose, the commis-
9 sioner of health is authorized to fund demonstrations that develop and
10 evaluate interventions targeted at medicaid beneficiaries who are other-
11 wise exempt or excluded from mandatory medicaid managed care and who
12 have multiple co-morbidities. Such interventions shall seek to increase
13 the coordination of care, ensure that care is delivered in the most
14 appropriate setting, improve health outcomes and reduce the cost of that
15 care.
16 3. Demonstrations established pursuant to this section may test models
17 of care and models of reimbursement, including shared savings, that are
18 intended to advance the goals described in subdivision two of this
19 section.
20 4. Service providers eligible to apply for roles as demonstration
21 service coordinators include: hospitals, diagnostic and treatment
22 centers, nursing homes, certified home health agencies, licensed home
23 care services agencies, long term home health care programs, managed
24 care plans, managed long term care plans, and providers licensed by or
25 funded by the office of mental health or the office of alcohol and
26 substance abuse services. The commissioner of health shall approve
27 chronic illness demonstration programs which are geographically diverse.
28 A participating service provider must establish, to the satisfaction of
29 the commissioner of health, its capacity to enroll and serve sufficient
30 numbers of enrollees to demonstrate the cost-effectiveness of the demon-
31 stration program.
32 5. Nothing in this section shall be construed as requiring any medi-
33 caid beneficiary to participate in a demonstration project established
34 pursuant to this section; participation shall be voluntary. Partic-
35 ipation in a demonstration project pursuant to this section shall not
36 diminish or impair the services to which a participant is otherwise
37 entitled under this chapter.
38 6. Prior to establishing any demonstration project authorized by this
39 section, the commissioner shall consult with the commissioners of the
40 office of mental health and the office of alcohol and substance abuse
41 services.
42 7. This section shall not apply unless all necessary approvals under
43 federal law and regulation have been obtained to receive federal finan-
44 cial participation in the costs of health care services provided pursu-
45 ant to this section. The commissioner of health is authorized to submit
46 one or more applications for waivers of the federal social security act
47 as may be necessary to obtain such federal financial participation.
48 8. The commissioner of health shall provide a report to the governor
49 and the legislature no later than January first, two thousand ten. The
50 report shall include findings as to the demonstration projects' effec-
51 tiveness in managing the care needs and improving the health of program
52 participants, an evaluation as to the programs' cost-effectiveness as
53 measured against traditional medicaid care models, and recommendations
54 as to whether the programs should be extended, modified, eliminated, or
55 made permanent.
S. 2108--C 123 A. 4308--C
1 § 3. The opening paragraph of paragraph (e) of subdivision 1 of
2 section 369-ee of the social services law, as added by chapter 1 of the
3 laws of 1999, is amended to read as follows:
4 "Health care services" means the following services and supplies as
5 defined by the commissioner in consultation with the superintendent of
6 insurance, except as provided in subdivision three-a of this section:
7 § 4. Paragraph (a) of subdivision 3 of section 369-ee of the social
8 services law, as added by chapter 1 of the laws of 1999, is amended to
9 read as follows:
10 (a) [Every] Except as provided in subdivision three-a of this section,
11 every person determined eligible for or receiving family health plus
12 coverage under this section shall enroll in a family health insurance
13 plan.
14 § 5. Section 369-ee of the social services law is amended by adding a
15 new subdivision 3-a to read as follows:
16 3-a. (a) A person who meets the requirements of subdivision two of
17 this section shall not be enrolled in, or shall be disenrolled from, a
18 family health insurance plan if a determination has been made that:
19 (i) the person has access to employer-sponsored health insurance, as
20 defined by the commissioner; and
21 (ii) furnishing the health care services described in paragraph (c) of
22 this subdivision is deemed cost effective by the commissioner.
23 (b) If a determination is made that a person meets the criteria set
24 forth in paragraph (a) of this subdivision, the person shall be required
25 to enroll in the employer-sponsored health insurance in order to receive
26 or continue to receive health care services under this section. A person
27 required to enroll in employer-sponsored health insurance pursuant to
28 this subdivision shall not, by virtue of having such insurance, be
29 deemed to have equivalent health care coverage for purposes of subpara-
30 graph (iii) of paragraph (a) of subdivision two of this section.
31 (c) With respect to a person described in paragraph (a) of this subdi-
32 vision who has enrolled in employer-sponsored health insurance pursuant
33 to paragraph (b) of this subdivision, health care services pursuant to
34 this title shall mean:
35 (i) payment or part-payment of the premium, co-insurance, any deduct-
36 ible amounts and other cost-sharing obligations for the person's employ-
37 er-sponsored health insurance that exceed the amount of the person's
38 co-payment obligation under subdivision two-a of this section; and
39 (ii) payment for services and supplies listed in paragraph (e) of
40 subdivision one of this section, subject to any limitations contained
41 therein and in paragraph (e-1) of such subdivision, but only to the
42 extent that such services and supplies are not covered by the person's
43 employer-sponsored health insurance.
44 § 6. Paragraphs (d) and (e) of subdivision 1 of section 4403-f of the
45 public health law, as added by chapter 659 of the laws of 1997, are
46 amended to read as follows:
47 (d) "Operating demonstration" means the following entities: [the
48 social health maintenance organization authorized by chapter six hundred
49 two of the laws of nineteen hundred eighty-two; and] the chronic care
50 management demonstration programs authorized by [chapters six hundred
51 fifty-three of the laws of nineteen hundred eighty-four,] chapter five
52 hundred thirty of the laws of nineteen hundred eighty-eight, chapter
53 five hundred ninety-seven of the laws of nineteen hundred ninety-four
54 and chapter eighty-one of the laws of nineteen hundred ninety-five as
55 amended.
S. 2108--C 124 A. 4308--C
1 (e) "Approved managed long term care demonstration" means the sites
2 approved by the commissioner to participate in the "Evaluated Medicaid
3 Long Term Care Capitation Program"[; the chronic care management demon-
4 stration program authorized by chapter thirty-nine of the laws of nine-
5 teen hundred ninety-seven; and any demonstration authorized pursuant to
6 paragraphs (d) and (e) of subdivision six of this section].
7 § 7. Paragraph (c) of subdivision 1 of section 4403-f of the public
8 health law is REPEALED and paragraphs (d), (e) and (f) are relettered
9 paragraphs (c), (d) and (e).
10 § 8. The opening paragraph of subdivision 2 of section 4403-f of the
11 public health law, as added by chapter 659 of the laws of 1997, is
12 amended to read as follows:
13 Certificate of authority; form. An eligible applicant shall submit an
14 application for a certificate of authority to operate a managed long
15 term care plan upon forms[, and within such time, as may be] prescribed
16 by the commissioner. Such eligible applicant shall submit information
17 and documentation to the commissioner which shall include, but not be
18 limited to:
19 § 9. Paragraph (d) of subdivision 2 of section 4403-f of the public
20 health law, as added by chapter 659 of the laws of 1997, is amended to
21 read as follows:
22 (d) adequate documentation of the appropriate licenses, certifications
23 or approvals to provide care as planned, including[, if appropriate,
24 affiliation agreements or] contracts with such providers as may be
25 necessary to provide the full complement of services required to be
26 provided under this section.
27 § 10. Paragraphs (f), (g), (h) and (i) of subdivision 3 of section
28 4403-f of the public health law, as added by chapter 659 of the laws of
29 1997, are amended and a new paragraph (j) is added to read as follows:
30 (f) readiness and capability to[:] achieve full capitation [on a sche-
31 duled basis] for services reimbursed pursuant to title XVIII of the
32 federal social security act [or capability and protocols for benefit
33 coordination for services reimbursed pursuant to such title and all
34 other applicable benefits, with such benefit coordination including, but
35 not limited to, measures to support sound clinical decisions, reduce
36 administrative complexity, coordinate access to services, maximize bene-
37 fits available pursuant to such title and ensure that necessary care is
38 provided];
39 (g) readiness and capability to achieve full capitation [on a sched-
40 uled basis] for services reimbursed pursuant to title XIX of the federal
41 social security act;
42 (h) willingness and capability of taking, or cooperating in, all steps
43 necessary to secure and integrate any potential sources of funding for
44 services provided by the managed long term care plan, including, but not
45 limited to, funding available under titles XVI, XVIII, XIX and XX of the
46 federal social security act, the federal older Americans act of nineteen
47 hundred sixty-five, as amended, or any successor provisions subject to
48 approval of the director of the state office for aging, and through
49 financing options such as those authorized pursuant to section three
50 hundred sixty-seven-f of the social services law; [and]
51 (i) that the arrangements for health and long term care services
52 ensure the availability and accessibility of such services to the
53 proposed enrolled population[.]; and
54 (j) that the applicant is financially responsible and may be expected
55 to meet its obligations to its enrolled members.
56 § 11. Intentionally omitted.
S. 2108--C 125 A. 4308--C
1 § 12. Subparagraph (iii) of paragraph (a) of subdivision 4 of section
2 4403-f of the public health law, as added by chapter 659 of the laws of
3 1997, is amended to read as follows:
4 (iii) shall establish reasonable capitalization and [contingency]
5 contingent reserve requirements. [Where the population enrolled in a
6 managed long term care plan is substantially composed of chronically ill
7 individuals receiving services under title XIX of the federal social
8 security act, the superintendent of insurance shall take into consider-
9 ation the availability of services to such chronically ill individuals
10 under such title in the event that the managed long term care plan is
11 unable to meet its contractual obligations. The establishment of reason-
12 able capitalization and contingency reserve requirements for managed
13 long term care plans substantially composed of chronically ill individ-
14 uals receiving services under title XIX of the federal social security
15 act shall also be subject to the approval of the commissioner;]
16 § 13. Subparagraph (iv) of paragraph (a) of subdivision 4 of section
17 4403-f of the public health law is REPEALED.
18 § 14. Paragraph (b) of subdivision 4 of section 4403-f of the public
19 health law, as added by chapter 659 of the laws of 1997, is amended to
20 read as follows:
21 (b) Standards established pursuant to this subdivision shall be
22 adequate to protect the interests of enrollees in managed long term care
23 plans. The superintendent of insurance shall be satisfied that the
24 eligible applicant is financially sound, and has made adequate
25 provisions to pay for services[:
26 (i) that are furnished by providers that are not affiliated with the
27 eligible applicant;
28 (ii) to meet the specialized health care needs of enrollees needing
29 care at specialty care centers; and
30 (iii) for which claims are submitted after the period for which the
31 eligible applicant will receive payments].
32 § 15. Subdivision 5 of section 4403-f of the public health law, as
33 added by chapter 659 of the laws of 1997, is amended to read as follows:
34 5. Applicability of other laws. [(a)] A managed long term care plan or
35 approved managed long term care demonstration shall be subject to the
36 provisions of the insurance law and regulations applicable to health
37 maintenance organizations, this article and regulations promulgated
38 pursuant thereto. To the extent that the provisions of this section are
39 inconsistent with the provisions of this chapter or the provisions of
40 the insurance law, the provisions of this section shall prevail.
41 [(b) Notwithstanding chapter thirty-nine of the laws of nineteen
42 hundred ninety-seven, the provisions of this section shall apply to the
43 chronic care management demonstration authorized by such chapter.]
44 § 16. Paragraph (a) of subdivision 6 of section 4403-f of the public
45 health law is REPEALED and a new paragraph (a) is added to read as
46 follows:
47 (a) An applicant shall be issued a certificate of authority as a
48 managed long term care plan upon a determination by the commissioner,
49 subject to any applicable evaluations, approvals, and regulations of the
50 superintendent of insurance as stated in this section, that the appli-
51 cant complies with the operating requirements for a managed long term
52 care plan under this section. The commissioner shall issue no more than
53 fifty certificates of authority to managed long term care plans pursuant
54 to this section. For purposes of issuance of no more than fifty certif-
55 icates of authority, such certificates shall include those certificates
56 issued pursuant to paragraphs (b) and (c) of this subdivision.
S. 2108--C 126 A. 4308--C
1 § 17. Paragraphs (d) and (f) of subdivision 6 of section 4403-f of the
2 public health law are REPEALED, paragraph (e), as amended by section 11
3 of part C of chapter 109 of the laws of 2006, is relettered paragraph
4 (d) and is amended to read as follows:
5 (d) The majority leader of the senate and the speaker of the assembly
6 may each designate in writing up to [ten] fifteen eligible applicants
7 [as] to apply to be approved managed long term care demonstrations or
8 plans. The commissioner may designate in writing up to [six] eleven
9 eligible applicants [as] to apply to be approved managed long term care
10 demonstrations or plans. [Subsequent to such designation, the commis-
11 sioner and the superintendent of insurance shall impose terms and condi-
12 tions pursuant to a written agreement with each such demonstration, not
13 inconsistent with this section, under which such demonstrations shall be
14 authorized to operate. If any such demonstration has not commenced oper-
15 ations by January first, two thousand four, the majority leader of the
16 senate or the speaker of the assembly, as the case may be, may, consist-
17 ent with this paragraph, rescind its designation as an approved managed
18 long term care demonstration and its authorization to operate, and,
19 consistent with this paragraph, designate an alternate applicant as an
20 approved managed long term care demonstration.]
21 § 18. Paragraphs (c) and (d) of subdivision 7 of section 4403-f of the
22 public health law, as added by chapter 659 of the laws of 1997, are
23 amended to read as follows:
24 (c)(i) [The commissioner may establish interim enrollment thresholds
25 which are less than the projected total enrollment in a plan for the
26 purpose of making a determination of the plan's ability to enroll addi-
27 tional persons above the established thresholds while providing high
28 quality and accessible care. Total enrollment of persons enrolled in
29 managed long term care plans certified under paragraph (a) of subdivi-
30 sion six of this section or initially authorized to operate as an
31 approved managed long term care demonstration under paragraph (e) of
32 such subdivision, shall not exceed, in the aggregate, twenty-five thou-
33 sand persons who were chronically ill and eligible for services under
34 title XIX of the federal social security act at the time of enrollment
35 and twenty-five thousand persons who were not chronically ill at the
36 time of enrollment.
37 (ii)] A managed long term care plan shall not use deceptive or coer-
38 cive marketing methods to encourage participants to enroll. A managed
39 long term care plan shall not distribute marketing materials to poten-
40 tial enrollees [until such plan has submitted] before such materials
41 [to] have been approved by the commissioner[, the superintendent of
42 insurance and the director of the state office for the aging].
43 [(iii)] (ii) The commissioner shall ensure, through periodic reviews
44 of managed long term care plans, that enrollment was a voluntary and
45 informed choice; such plan has only enrolled persons whom it is author-
46 ized to enroll, and plan services are promptly available to enrollees
47 when appropriate. Such periodic reviews shall be made according to stan-
48 dards as determined by the commissioner in regulations.
49 (d) Notwithstanding any provision of law, rule or regulation to the
50 contrary [and subject to the availability of funds], the commissioner
51 [shall] may issue a request for proposals to carry out reviews of
52 enrollment and assessment activities in managed long term care plans and
53 operating demonstrations with respect to enrollees eligible to receive
54 services under title XIX of the federal social security act to determine
55 if enrollment meets the requirements of subparagraph [(iii)] (ii) of
56 paragraph (c) of this subdivision; and that assessments of such enrol-
S. 2108--C 127 A. 4308--C
1 lees' health, functional and other status, for the purpose of adjusting
2 premiums, were accurate. [The request for proposals shall be developed,
3 and proposals evaluated, in consultation with the local commissioners
4 representing the several regions of the state.] Evaluations shall
5 address each bidder's ability to ensure that enrollments in such plans
6 are promptly reviewed and that medical assistance required to be
7 furnished pursuant to title eleven of article five of the social
8 services law will be appropriately furnished to the recipients for whom
9 the local commissioners are responsible pursuant to section three
10 hundred sixty-five of such title and that plan implementation will be
11 consistent with the proper and efficient administration of the medical
12 assistance program and managed long term care plans.
13 § 19. Subparagraph (iii) of paragraph (k) of subdivision 7 of section
14 4403-f of the public health law, as added by section 65-c of part A of
15 chapter 57 of the laws of 2006, is amended to read as follows:
16 (iii) The completed assessment and documentation of the enrollment
17 shall be submitted by the managed long term care plan or demonstration
18 to the local department of social services, or to a contractor selected
19 pursuant to paragraph (d) of this subdivision, prior to the commencement
20 of services under the managed long term care plan or demonstration. For
21 purposes of reimbursement of the managed long term care plan or demon-
22 stration, if the completed assessment and documentation are submitted on
23 or before the twentieth day of the month, the enrollment shall commence
24 on the first day of the month following the completion and submission
25 and if the completed assessment and documentation are submitted after
26 the twentieth day of the month, the enrollment shall commence on the
27 first day of the second month following submission. Enrollments
28 conducted by a plan or demonstration shall be subject to review and
29 audit by the department and by the local social services district or a
30 contractor selected pursuant to paragraph (d) of this subdivision.
31 § 20. Paragraphs (e), (f) and (g) of subdivision 7 of section 4403-f
32 of the public health law are REPEALED and paragraphs (h), (i), (j), (k)
33 and (l) are relettered paragraphs (e), (f), (g), (h) and (i).
34 § 21. Subdivision 8 of section 4403-f of the public health law, as
35 amended by section 65-g of part A of chapter 57 of the laws of 2006, is
36 amended to read as follows:
37 8. Payment rates for managed long term care plan enrollees eligible
38 for medical assistance. The commissioner[, in consultation with the
39 superintendent of insurance,] shall establish payment rates for services
40 provided to enrollees eligible under title XIX of the federal social
41 security act. Such payment rates shall be subject to approval by the
42 director of the division of the budget and shall reflect savings to both
43 state and local governments when compared to costs which would be
44 incurred by such program if enrollees were to receive comparable health
45 and long term care services on a fee-for-service basis in the geographic
46 region in which such services are proposed to be provided. Payment rates
47 shall be risk-adjusted to take into account the characteristics of
48 enrollees, or proposed enrollees, including, but not limited to: frail-
49 ty, disability level, health and functional status, age, gender, the
50 nature of services provided to such enrollees, and other factors as
51 determined by the commissioner [in consultation with the superintendent
52 of insurance]. The risk adjusted premiums may also be combined with
53 disincentives or requirements designed to mitigate any incentives to
54 obtain higher payment categories.
55 § 22. Subdivision 10 of section 4403-f of the public health law is
56 REPEALED and subdivision 11 is renumbered subdivision 10.
S. 2108--C 128 A. 4308--C
1 § 22-a. Section 88 of chapter 659 of the laws of 1997, constituting
2 the long term care integration and finance act of 1997, as amended by
3 chapter 346 of the laws of 2005, is amended to read as follows:
4 § 88. Notwithstanding any provision of law to the contrary, all oper-
5 ating demonstrations, as such term is defined in paragraph (d) of subdi-
6 vision 1 of section 4403-f of the public health law as added by section
7 eighty-two of this act, due to expire prior to January 1, 2001 shall be
8 deemed to expire on December 31, [2007] 2009.
9 § 23. Subparagraph (ii) of paragraph (b) of subdivision 9 of section
10 367-a of the social services law, as amended by section 32 of part C of
11 chapter 109 of the laws of 2006, is amended to read as follows:
12 (ii) if the drug dispensed is a multiple source prescription drug or a
13 brand-name prescription drug for which no specific upper limit has been
14 set by such federal agency, the lower of the estimated acquisition cost
15 of such drug to pharmacies, or the dispensing pharmacy's usual and
16 customary price charged to the general public. For sole and multiple
17 source brand name drugs, estimated acquisition cost means the average
18 wholesale price of a prescription drug based upon the package size
19 dispensed from, as reported by the prescription drug pricing service
20 used by the department, less [thirteen and twenty-five hundredths of
21 one] fourteen percent thereof, and updated monthly by the department;
22 or, for a specialized HIV pharmacy, as defined in paragraph (f) of this
23 subdivision, acquisition cost means the average wholesale price of a
24 prescription drug based upon the package size dispensed from, as
25 reported by the prescription drug pricing service used by the depart-
26 ment, less twelve percent thereof, and updated monthly by the depart-
27 ment. For multiple source generic drugs, estimated acquisition cost
28 means the lower of the average wholesale price of a prescription drug
29 based on the package size dispensed from, as reported by the
30 prescription drug pricing service used by the department, less [twenty]
31 twenty-five percent thereof, or the maximum acquisition cost, if any,
32 established pursuant to paragraph (e) of this subdivision; or, for a
33 specialized HIV pharmacy, as defined in paragraph (f) of this subdivi-
34 sion, acquisition cost means the lower of the average wholesale price of
35 a prescription drug based on the package size dispensed from, as
36 reported by the prescription drug pricing service used by the depart-
37 ment, less twelve percent thereof, or the maximum acquisition cost, if
38 any, established pursuant to paragraph (e) of this subdivision.
39 § 24. Intentionally Omitted.
40 § 25. Intentionally Omitted.
41 § 26. Intentionally Omitted.
42 § 27. Intentionally Omitted.
43 § 28. Intentionally Omitted.
44 § 29. 1. Notwithstanding paragraph (c) of subdivision 10 of section
45 2807-c of the public health law, subdivision 2-b of section 2808 of the
46 public health law and section 21 of chapter 1 of the laws of 1999 and
47 any other inconsistent provision of law or regulation to the contrary,
48 in determining rates of payments by state governmental agencies effec-
49 tive for services provided on and after April 1, 2007, for inpatient and
50 outpatient services provided by general hospitals and for inpatient
51 services and outpatient adult day health care services provided by resi-
52 dential health care facilities pursuant to article 28 of the public
53 health law, except for residential health care facilities that provide
54 extensive nursing, medical, psychological and counseling support
55 services to children, the commissioner of health shall apply a trend
56 factor projection equal to seventy-five percent of the otherwise appli-
S. 2108--C 129 A. 4308--C
1 cable trend factor projection attributable to the period January 1, 2007
2 through December 31, 2007 in accordance with paragraph (c) of subdivi-
3 sion 10 of section 2807-c of the public health law.
4 2. The commissioner of health shall adjust rates of payment to reflect
5 the exclusion pursuant to this section of such specified trend factor
6 projections or adjustments.
7 § 30. Subparagraph (v) of paragraph (a) of subdivision 2 of section
8 2807-d of the public health law, as added by section 18 of part C of
9 chapter 58 of the laws of 2005, is amended to read as follows:
10 (v) Notwithstanding any contrary provisions of this paragraph or any
11 other provision of law or regulation, for general hospitals the assess-
12 ment shall be thirty-five hundredths of one percent of each general
13 hospital's gross receipts received from all patient care services and
14 other operating income on a cash basis for the period April first, two
15 thousand five through March thirty-first two thousand seven for hospital
16 or health-related services, including, but not limited to inpatient
17 service, outpatient service, emergency service, referred ambulatory
18 service and ambulatory surgical services, but not including residential
19 health care facilities services or home health care services.
20 [Provided, however, the assessment shall not be collected in excess of
21 one hundred six million fifteen thousand dollars for each of the periods
22 April first, two thousand five through March thirty-first, two thousand
23 six and April first, two thousand six through March thirty-first, two
24 thousand seven. The amount of the assessment collected in excess of such
25 amount shall be refunded to general hospitals based on the ratio which a
26 general hospital's assessment for such period bears to the total of the
27 assessments for such period paid by general hospitals.]
28 § 31. Intentionally omitted.
29 § 32. Intentionally Omitted.
30 § 33. Subparagraphs (i) and (ii) of paragraph (d) of subdivision 25 of
31 section 2807-c of the public health law, as added by section 7 of part B
32 of chapter 58 of the laws of 2004, are amended to read as follows:
33 (i) For periods on and after April first, two thousand four, the
34 commissioner shall adjust inpatient medical assistance rates of payment
35 established pursuant to this section, including discrete rates of
36 payment calculated pursuant to paragraph a-three of subdivision one of
37 this section, for non-public general hospitals, and for periods on and
38 after April first, two thousand seven, for public and non-public general
39 hospitals, in accordance with subparagraph (ii) of this paragraph, for
40 purposes of reimbursing graduate medical education costs based on the
41 following methodology:
42 (ii) Rate adjustments for each [non-public] general hospital shall be
43 based on the difference between the graduate medical education compo-
44 nent, direct and indirect, of the two thousand three medical assistance
45 inpatient rates of payment, including exempt unit per diem rates, and an
46 estimate of what the graduate medical education component, direct and
47 indirect, of such medical assistance inpatient rates of payment, includ-
48 ing exempt unit per diem rates would be, stated at two thousand three
49 levels and calculated as follows:
50 (A) Each [non-public] general hospital's total direct medical educa-
51 tion costs as reported in the two thousand one institutional cost report
52 submitted as of December thirty-first, two thousand three, and
53 (B) An estimate of the total indirect medical education costs for two
54 thousand one calculated in accordance with the methodology applicable
55 for purposes of determining an estimate of indirect medical education
56 costs pursuant to subparagraph (ii) of paragraph (c) of subdivision
S. 2108--C 130 A. 4308--C
1 seven of this section. The indirect medical education costs shall equal
2 the product of two thousand one hospital specific inpatient operating
3 costs, including exempt unit costs, and the indirect teaching cost
4 percentage determined by the following formula:
5 1-(1/(1+1.89(((1+r) .405)-1)))
6 where r equals the ratio of residents and fellows to beds for two thou-
7 sand one adjusted to reflect the projected two thousand three resident
8 counts.
9 (C) Each hospital's rate adjustment shall be limited to seventy-five
10 percent of the graduate medical education component included in its two
11 thousand three medical assistance inpatient rates of payment, including
12 exempt unit rates. For periods on and after April first, two thousand
13 seven, the seventy-five percent limit shall not apply to rate decreases
14 calculated pursuant to this paragraph.
15 (D) [No] For the period April first, two thousand four through March
16 thirty-first, two thousand seven, no hospital shall receive a rate
17 adjustment pursuant to this paragraph if such rate adjustment would be a
18 negative amount. For periods on and after April first, two thousand
19 seven, no public general hospital shall receive a rate increase calcu-
20 lated pursuant to this paragraph.
21 § 34. Paragraph (c) of subdivision 3 of section 2807-c of the public
22 health law, as amended by chapter 1 of the laws of 1999, is amended to
23 read as follows:
24 (c) (i) The commissioner shall determine an appropriate weighting
25 factor for each diagnosis-related group which reflects the relative
26 general hospital resources used by all patients, other than benefici-
27 aries of title XVIII of the federal social security act (medicare), with
28 respect to discharges classified within that diagnosis-related group
29 compared to discharges classified within other diagnosis-related groups.
30 For rate periods during the period January first, nineteen hundred
31 eighty-eight through December thirty-first, nineteen hundred ninety, the
32 appropriate weighting factor for each diagnosis-related group shall be
33 determined using nineteen hundred eighty-five costs and statistics for a
34 representative sample of general hospitals. For rate periods during the
35 period January first, nineteen hundred ninety-one through December thir-
36 ty-first, nineteen hundred ninety-three, the appropriate weighting
37 factor for each diagnosis-related group shall be determined using nine-
38 teen hundred eighty-nine costs and statistics for a representative
39 sample of general hospitals. For rate periods during the period January
40 first, nineteen hundred ninety-four through December thirty-first, nine-
41 teen hundred ninety-nine and on and after January first, two thousand[,]
42 through December thirty-first, two thousand seven, the appropriate
43 weighting factor for each diagnosis-related group shall be determined
44 using nineteen hundred ninety-two costs and statistics for a represen-
45 tative sample of general hospitals. For rate periods on and after Janu-
46 ary first, two thousand eight, the appropriate weighting factor for each
47 diagnosis-related group shall be determined using two thousand four
48 costs and statistics for a representative sample of general hospitals,
49 and, further, the computation of the group average arithmetic inlier
50 length-of-stays for each diagnostic related group, as otherwise deter-
51 mined in accordance with applicable regulations, shall utilize two thou-
52 sand four data as reported to the department, and, be based on a repre-
53 sentative sample of general hospitals, and further, the short-stay and
54 long-stay length-of-stay trimpoints, as otherwise determined in accord-
55 ance with applicable regulations, shall be computed utilizing two thou-
56 sand four data as reported to the department and based on a represen-
S. 2108--C 131 A. 4308--C
1 tative sample of general hospitals. Provided however, that if the
2 department does not release updated data and documentation described in
3 subparagraph (iii) of this paragraph, the effective rate period shall be
4 April 1, 2008. Discharges and costs related to the exceptions to case
5 payment provided in accordance with paragraphs (e), (g) and (i) of
6 subdivision four of this section shall be eliminated from the costs and
7 statistics used in determining the appropriate weighting factors, while
8 the cost factor related to the exception provided in paragraph (h) of
9 subdivision four of this section shall be eliminated. The costs and
10 statistics for the case payment modifications calculated pursuant to
11 paragraphs (a), (b), (c) and (d) of subdivision four of this section
12 shall be eliminated in accordance with paragraph (c) of subdivision six
13 of this section. Costs related to education, physician, ambulance
14 services and organ acquisition identified consistent with the provisions
15 of paragraph (c) of subdivision seven of this section and costs related
16 to malpractice insurance shall also be eliminated. The council may adopt
17 rules and regulations, subject to the approval of the commissioner, to
18 prospectively adjust weighting factors determined in accordance with
19 this paragraph to reflect changes in medical technology. After the
20 commissioner issues rate certifications pursuant to subdivision four of
21 section twenty-eight hundred seven of this article the commissioner
22 shall expeditiously make available for inspection by general hospitals
23 and payors the data, consistent with appropriate department procedures
24 for the release and protection of confidential data, and the methodology
25 utilized to determine the appropriate weighting factors.
26 (ii) Notwithstanding any contrary provision of law, the case mix
27 adjustment to the operating component of per diem rates of payment paid
28 to general hospitals or units of general hospitals that are exempt from
29 case based payments, as determined in accordance with subdivision four
30 of this section and as otherwise computed in accordance with applicable
31 regulations, shall, for periods on and after January first, two thousand
32 eight, be computed utilizing the diagnosis-related group classification
33 system in effect for the rate year for inpatient case based medicaid
34 rates of payment and the related per day cost weights calculated using
35 two thousand four data as reported to the department and based on a
36 representative sample of general hospitals. For rate periods on and
37 after the two thousand eleven rate period, such case mix adjustment
38 shall utilize the same base period data as determined in accordance with
39 paragraph (e) of this subdivision.
40 (iii) The department shall, by no later than June first, two thousand
41 seven, make available to hospital industry representatives relevant
42 updated data and documentation that the department will utilize, in
43 accordance with this paragraph, in developing appropriate service inten-
44 sity weights for each diagnosis-related group for the two thousand eight
45 rate period. The department will thereafter consult with hospital indus-
46 try representatives in developing regulations to implement the utiliza-
47 tion of such updated service intensity weight data applicable to rate
48 periods on and after two thousand eight. If it is deemed appropriate by
49 the commissioner, in consultation with hospital industry represen-
50 tatives, such regulations may provide for the phase-in over a period of
51 time of the application of such updated data in determining Medicaid
52 rates on and after two thousand eight, provided, however, that the
53 application of such updated data shall be fully reflected in such rates
54 by no later than January first, two thousand ten.
55 (iv) By no later than December first, two thousand seven, the commis-
56 sioner shall issue a report to the governor and the legislature describ-
S. 2108--C 132 A. 4308--C
1 ing the updated data utilization applicable, in accordance with the
2 provisions of this paragraph, to periods on and after two thousand eight
3 and setting forth the factors considered in developing it.
4 § 34-a. Subdivision 3 of section 2807-c of the public health law is
5 amended by adding a new paragraph (e) to read as follows:
6 (e) The appropriate weighting factor for each diagnosis-related group,
7 the group average arithmetic inlier length-of-stays for each diagnosis-
8 related group, and the short-stay and long-stay length-of-stay trim-
9 points shall, by no later than the two thousand eleven rate period, be
10 based on reported costs and statistics from a representative sample of
11 general hospitals from a base period no earlier than two thousand seven.
12 Thereafter, the base period reported costs and statistics utilized for
13 such purposes shall be updated no less frequently than every four years
14 and the new base periods utilized shall be no more than four years prior
15 to the applicable rate period.
16 § 34-b. Notwithstanding paragraph (c) of subdivision 3 of section
17 2807-c of the public health law and any other contrary provision of law,
18 with regard to adjustments to medical assistance rates of payment for
19 rate periods on and after January 1, 2008, made pursuant to paragraph
20 (c) of subdivision 3 of section 2807-c of the public health law the
21 commissioner of health and the director of the budget shall, upon a
22 determination that such adjustments shall result in an aggregate
23 increase or decrease in total medicaid payments to general hospitals for
24 inpatient services, make such proportional adjustments to such rates of
25 payments as are necessary to reduce or increase such total aggregate
26 payments such that the aggregate total reflects no such increase or
27 decrease.
28 § 35. Intentionally omitted.
29 § 36. Subdivision 2-b of section 2808 of the public health law is
30 amended by adding a new paragraph (g) to read as follows:
31 (g) Notwithstanding any contrary provision of this subdivision or any
32 other contrary provision of law, rule or regulation, rates of payment
33 for inpatient services provided on and after April first, two thousand
34 nine by residential health care facilities shall, except for the estab-
35 lishment of any statewide or any peer group base, mean or ceiling prices
36 per day, be calculated utilizing only the number of patients properly
37 assessed and reported in each patient classification group and eligible
38 for medical assistance pursuant to title eleven of article five of the
39 social services law.
40 § 37. Subparagraph (vi) of paragraph (b) of subdivision 2 of section
41 2807-d of the public health law, as amended by section 20 of part C of
42 chapter 109 of the laws of 2006, is amended to read as follows:
43 (vi) Notwithstanding any contrary provision of this paragraph or any
44 other provision of law or regulation to the contrary, for residential
45 health care facilities the assessment shall be six percent of each resi-
46 dential health care facility's gross receipts received from all patient
47 care services and other operating income on a cash basis for the period
48 April first, two thousand two through March thirty-first, two thousand
49 three for hospital or health-related services, including adult day
50 services; provided, however, that residential health care facilities'
51 gross receipts attributable to payments received pursuant to title XVIII
52 of the federal social security act (medicare) shall be excluded from the
53 assessment; provided, however, that for all such gross receipts received
54 on or after April first, two thousand three through March thirty-first,
55 two thousand five, such assessment shall be five percent, and further
56 provided that for all such gross receipts received on or after April
S. 2108--C 133 A. 4308--C
1 first, two thousand five through March thirty-first, two thousand nine,
2 and on or after April first, two thousand nine through March thirty-
3 first, two thousand eleven such assessment shall be six percent.
4 § 38. Intentionally omitted.
5 § 39. The state finance law is amended by adding a new article 13 to
6 read as follows:
7 ARTICLE XIII
8 NEW YORK FALSE CLAIMS ACT
9 Section 187. Short title.
10 188. Definitions.
11 189. Liability for certain acts.
12 190. Civil actions for false claims.
13 191. Remedies of employees.
14 192. Limitation of actions, burden of proof.
15 193. Other law enforcement authority and duties.
16 194. Regulations.
17 § 187. Short title. This article shall be known and may be cited as
18 the "New York false claims act".
19 § 188. Definitions. As used in this article, the following terms shall
20 mean:
21 1. "Claim" means any request or demand, whether under a contract or
22 otherwise, for money or property which is made to any employee, officer,
23 or agent of the state or a local government, or to any contractor, gran-
24 tee or other recipient, if the state or a local government provides any
25 portion of the money or property which is requested or demanded or will
26 reimburse such contractor, grantee, or other recipient for any portion
27 of the money or property which is requested or demanded.
28 2. "False claim" means any claim which is, either in whole or part,
29 false or fraudulent.
30 3. "Knowing and knowingly" means that with respect to a claim, or
31 information relating to a claim, a person:
32 (a) has actual knowledge of such claim or information;
33 (b) acts in deliberate ignorance of the truth or falsity of such claim
34 or information; or
35 (c) acts in reckless disregard of the truth or falsity of such claim
36 or information.
37 Proof of specific intent to defraud is not required, provided, however
38 that acts occurring by mistake or as a result of mere negligence are not
39 covered by this article.
40 4. "Local government" means any county, city, town, village, school
41 district, board of cooperative educational services, local public bene-
42 fit corporation or other municipal corporation or political subdivision
43 of the state.
44 5. "Original source" means a person who has direct and independent
45 knowledge of the information on which allegations are based, and has
46 voluntarily provided the information to the state or a local government
47 before filing an action under this article which is based on the infor-
48 mation.
49 6. "Person" means any natural person, partnership, corporation, asso-
50 ciation or any other legal entity or individual, other than the state or
51 a local government.
52 7. "State" means the state of New York and any state department,
53 board, bureau, division, commission, committee, public benefit corpo-
S. 2108--C 134 A. 4308--C
1 ration, public authority, council, office or other governmental entity
2 performing a governmental or proprietary function for the state.
3 § 189. Liability for certain acts. 1. Subject to the provisions of
4 subdivision two of this section, any person who:
5 (a) knowingly presents, or causes to be presented, to any employee,
6 officer or agent of the state or a local government, a false or fraudu-
7 lent claim for payment or approval;
8 (b) knowingly makes, uses, or causes to be made or used, a false
9 record or statement to get a false or fraudulent claim paid or approved
10 by the state or a local government;
11 (c) conspires to defraud the state or a local government by getting a
12 false or fraudulent claim allowed or paid;
13 (d) has possession, custody, or control of property or money used, or
14 to be used, by the state or a local government and, intending to defraud
15 the state or a local government or willfully to conceal the property or
16 money, delivers, or causes to be delivered, less property or money than
17 the amount for which the person receives a certificate or receipt;
18 (e) is authorized to make or deliver a document certifying receipt of
19 property used, or to be used, by the state or a local government and,
20 intending to defraud the state or a local government, makes or delivers
21 the receipt without completely knowing that the information on the
22 receipt is true;
23 (f) knowingly buys, or receives as a pledge of an obligation or debt,
24 public property from an officer or employee of the state or a local
25 government knowing that the officer or employee lawfully may not sell or
26 pledge the property; or
27 (g) knowingly makes, uses, or causes to be made or used, a false
28 record or statement to conceal, avoid, or decrease an obligation to pay
29 or transmit money or property to the state or a local government;
30 shall be liable: (i) to the state for a civil penalty of not less than
31 six thousand dollars and not more than twelve thousand dollars, plus
32 three times the amount of damages which the state sustains because of
33 the act of that person; and (ii) to any local government for three times
34 the amount of damages sustained by such local government because of the
35 act of that person.
36 2. The court may assess not more than two times the amount of damages
37 sustained because of the act of the person described in subdivision one
38 of this section, if the court finds that:
39 (a) the person committing the violation of this section had furnished
40 all information known to such person about the violation, to those offi-
41 cials responsible for investigating false claims violations on behalf of
42 the state and any local government that sustained damages, within thirty
43 days after the date on which such person first obtained the information;
44 (b) such person fully cooperated with any government investigation of
45 such violation; and
46 (c) at the time such person furnished information about the violation,
47 no criminal prosecution, civil action, or administrative action had
48 commenced with respect to such violation, and the person did not have
49 actual knowledge of the existence of an investigation into such
50 violation.
51 3. A person who violates this section shall also be liable for the
52 costs, including attorneys' fees, of a civil action brought to recover
53 any such penalty or damages.
54 4. This section shall not apply to claims, records, or statements made
55 under the tax law.
S. 2108--C 135 A. 4308--C
1 § 190. Civil actions for false claims. 1. Civil enforcement actions.
2 The attorney general shall have the authority to investigate violations
3 under section one hundred eighty-nine of this article. If the attorney
4 general believes that a person has violated or is violating such
5 section, then the attorney general may bring a civil action on behalf of
6 the people of the state of New York or on behalf of a local government
7 against such person. A local government also shall have the authority
8 to investigate violations that may have resulted in damages to such
9 local government under section one hundred eighty-nine of this article,
10 and may bring a civil action on its own behalf to recover damages
11 sustained by such local government as a result of such violations. No
12 action may be filed pursuant to this subdivision against the federal
13 government, the state or a local government, or any officer or employee
14 thereof acting in his or her official capacity. The attorney general
15 shall consult with the office of medicaid inspector general prior to
16 filing any action related to the medicaid program.
17 2. Qui tam civil actions. (a) Any person may bring a qui tam civil
18 action for a violation of section one hundred eighty-nine of this arti-
19 cle on behalf of the people of the state of New York or a local govern-
20 ment. No action may be filed pursuant to this subdivision against the
21 federal government, the state or a local government, or any officer or
22 employee thereof acting in his or her official capacity.
23 (b) A copy of the complaint and written disclosure of substantially
24 all material evidence and information the person possesses shall be
25 served on the state pursuant to subdivision one of section three hundred
26 seven of the civil practice law and rules. The complaint shall be filed
27 in supreme court in camera, shall remain under seal for at least sixty
28 days, and shall not be served on the defendant until the court so
29 orders. If the allegations in the complaint allege a violation of
30 section one hundred eighty-nine of this article involving damages to a
31 local government, then the attorney general may at any time provide a
32 copy of such complaint and written disclosure to the attorney for such
33 local government; provided, however, that if the allegations in the
34 complaint involve damages only to a city with a population of one
35 million or more, or only to the state and such a city, then the attorney
36 general shall provide such complaint and written disclosure to the
37 corporation counsel of such city within thirty days. The state may
38 elect to supersede or intervene and proceed with the action, or to
39 authorize a local government that may have sustained damages to super-
40 sede or intervene, within sixty days after it receives both the
41 complaint and the material evidence and information; provided, however,
42 that if the allegations in the complaint involve damages only to a city
43 with a population of one million or more, then the attorney general may
44 not supersede or intervene in such action without the consent of the
45 corporation counsel of such city. The attorney general shall consult
46 with the office of the medicaid inspector general prior to superseding
47 or intervening in any action related to the medicaid program. The
48 attorney general may, for good cause shown, move the court for exten-
49 sions of the time during which the complaint remains under seal under
50 this subdivision. Any such motions may be supported by affidavits or
51 other submissions in camera.
52 (c) Prior to the expiration of the sixty day period or any extensions
53 obtained under paragraph (b) of this subdivision, the attorney general
54 shall notify the court that he or she:
55 (i) intends to file a complaint against the defendant on behalf of the
56 people of the state of New York or a local government, and thereby be
S. 2108--C 136 A. 4308--C
1 substituted as the plaintiff in the action and convert the action in all
2 respects from a qui tam civil action brought by a private person into a
3 civil enforcement action by the attorney general under subdivision one
4 of this section;
5 (ii) intends to intervene in such action, as of right, so as to aid
6 and assist the plaintiff in the action; or
7 (iii) if the action involves damages sustained by a local government,
8 intends to grant the local government permission to: (A) file and serve
9 a complaint against the defendant, and thereby be substituted as the
10 plaintiff in the action and convert the action in all respects from a
11 qui tam civil action brought by a private person into a civil enforce-
12 ment action by the local government under subdivision one of this
13 section; or (B) intervene in such action, as of right, so as to aid and
14 assist the plaintiff in the action.
15 The attorney general shall provide the local government with a copy of
16 any such notification at the same time the court is notified.
17 (d) If the state notifies the court that it intends to file a
18 complaint against the defendant and thereby be substituted as the plain-
19 tiff in the action, or to permit a local government to do so, such
20 complaint must be filed within thirty days after the notification to the
21 court.
22 (e) If the state notifies the court that it intends to intervene in
23 the action, or to permit a local government to do so, then such motion
24 for intervention shall be filed within thirty days after the notifica-
25 tion to the court.
26 (f) If the state declines to participate in the action or to authorize
27 participation by a local government, the qui tam action may proceed
28 subject to judicial review under this section, the civil practice law
29 and rules, and other applicable law.
30 3. Time to answer. If the state decides to participate in a qui tam
31 action or to authorize the participation of a local government, the
32 court shall order that the qui tam complaint be unsealed and served at
33 the time of the filing of the complaint or intervention motion by the
34 state or local government. After the complaint is unsealed, or if a
35 complaint is filed by the state or a local government pursuant to subdi-
36 vision one of this section, the defendant shall be served with the
37 complaint and summons pursuant to article three of the civil practice
38 law and rules. A copy of any complaint which alleges that damages were
39 sustained by a local government shall also be served on such local
40 government. The defendant shall be required to respond to the summons
41 and complaint within the time allotted under rule three hundred twenty
42 of the civil practice law and rules.
43 4. Related actions. When a person brings a qui tam action under this
44 section, no person other than the attorney general, or a local govern-
45 ment attorney acting pursuant to subdivision one of this section or
46 paragraph (b) of subdivision two of this section, may intervene or bring
47 a related civil action based upon the facts underlying the pending
48 action, unless such other person has first obtained the permission of
49 the attorney general to intervene or to bring such related action;
50 provided, however, that nothing in this subdivision shall be deemed to
51 deny persons the right, upon leave of court, to file briefs amicus curi-
52 ae.
53 5. Rights of the parties of qui tam actions. (a) If the attorney
54 general elects to convert the qui tam civil action into an attorney
55 general enforcement action, then the state shall have the primary
56 responsibility for prosecuting the action. If the attorney general
S. 2108--C 137 A. 4308--C
1 elects to intervene in the qui tam civil action then the state and the
2 person who commenced the action, and any local government which
3 sustained damages and intervenes in the action, shall share primary
4 responsibility for prosecuting the action. If the attorney general
5 elects to permit a local government to convert the action into a civil
6 enforcement action, then the local government shall have primary respon-
7 sibility for investigating and prosecuting the action. If the action
8 involves damages to a local government but not the state, and the local
9 government intervenes in the qui tam civil action, then the local
10 government and the person who commenced the action shall share primary
11 responsibility for prosecuting the action. Under no circumstances shall
12 the state or a local government be bound by an act of the person bring-
13 ing the original action. Such person shall have the right to continue as
14 a party to the action, subject to the limitations set forth in paragraph
15 (b) of this subdivision. Under no circumstances shall the state be
16 bound by the act of a local government that intervenes in an action
17 involving damages to the state. If neither the attorney general nor a
18 local government intervenes in the qui tam action then the qui tam
19 plaintiff shall have the responsibility for prosecuting the action,
20 subject to the attorney general's right to intervene at a later date
21 upon a showing of good cause.
22 (b)(i) The state may move to dismiss the action notwithstanding the
23 objections of the person initiating the action if the person has been
24 served with the motion to dismiss and the court has provided the person
25 with an opportunity to be heard on the motion. If the action involves
26 damages to both the state and a local government, then the state shall
27 consult with such local government before moving to dismiss the action.
28 If the action involves damages sustained by a local government but not
29 the state, then the local government may move to dismiss the action
30 notwithstanding the objections of the person initiating the action if
31 the person has been served with the motion to dismiss and the court has
32 provided the person with an opportunity to be heard on the motion.
33 (ii) The state or a local government may settle the action with the
34 defendant notwithstanding the objections of the person initiating the
35 action if the court determines, after an opportunity to be heard, that
36 the proposed settlement is fair, adequate, and reasonable with respect
37 to all parties under all the circumstances. Upon a showing of good
38 cause, such opportunity to be heard may be held in camera.
39 (iii) Upon a showing by the attorney general or a local government
40 that the original plaintiff's unrestricted participation during the
41 course of the litigation would interfere with or unduly delay the prose-
42 cution of the case, or would be repetitious or irrelevant, or upon a
43 showing by the defendant that the original qui tam plaintiff's unre-
44 stricted participation during the course of the litigation would be for
45 purposes of harassment or would cause the defendant undue burden, the
46 court may, in its discretion, impose limitations on the original
47 plaintiff's participation in the case, such as:
48 (A) limiting the number of witnesses the person may call;
49 (B) limiting the length of the testimony of such witnesses;
50 (C) limiting the person's cross-examination of witnesses; or
51 (D) otherwise limiting the participation by the person in the liti-
52 gation.
53 (c) Notwithstanding any other provision of law, whether or not the
54 attorney general or a local government elects to supersede or intervene
55 in a qui tam civil action, the attorney general and such local govern-
56 ment may elect to pursue any remedy available with respect to the crimi-
S. 2108--C 138 A. 4308--C
1 nal or civil prosecution of the presentation of false claims, including
2 any administrative proceeding to determine a civil money penalty or to
3 refer the matter to the office of the medicaid inspector general for
4 medicaid related matters. If any such alternate civil remedy is pursued
5 in another proceeding, the person initiating the action shall have the
6 same rights in such proceeding as such person would have had if the
7 action had continued under this section.
8 (d) Notwithstanding any other provision of law, whether or not the
9 attorney general elects to supersede or intervene in a qui tam civil
10 action, or to permit a local government to supersede or intervene in the
11 qui tam civil action, upon a showing by the state or local government
12 that certain actions of discovery by the person initiating the action
13 would interfere with the state's or a local government's investigation
14 or prosecution of a criminal or civil matter arising out of the same
15 facts, the court may stay such discovery for a period of not more than
16 sixty days. Such a showing shall be conducted in camera. The court may
17 extend the period of such stay upon a further showing in camera that the
18 state or a local government has pursued the criminal or civil investi-
19 gation or proceedings with reasonable diligence and any proposed discov-
20 ery in the civil action will interfere with the ongoing criminal or
21 civil investigation or proceedings.
22 6. Awards to qui tam plaintiff. (a) If the attorney general elects to
23 convert the qui tam civil action into an attorney general enforcement
24 action, or to permit a local government to convert the action into a
25 civil enforcement action by such local government, or if the attorney
26 general or a local government elects to intervene in the qui tam civil
27 action, then the person or persons who initiated the qui tam civil
28 action collectively shall be entitled to receive between fifteen and
29 twenty-five percent of the proceeds recovered in the action or in
30 settlement of the action. The court shall determine the percentage of
31 the proceeds to which a person commencing a qui tam civil action is
32 entitled, by considering the extent to which the plaintiff substantially
33 contributed to the prosecution of the action. Where the court finds that
34 the action was based primarily on disclosures of specific information
35 (other than information provided by the person bringing the action)
36 relating to allegations or transactions in a criminal, civil or adminis-
37 trative hearing, in a legislative or administrative report, hearing,
38 audit or investigation, or from the news media, the court may award such
39 sums as it considers appropriate, but in no case more than ten percent
40 of the proceeds, taking into account the significance of the information
41 and the role of the person or persons bringing the action in advancing
42 the case to litigation.
43 (b) If the attorney general or a local government does not elect to
44 intervene or convert the action, and the action is successful, then the
45 person or persons who initiated the qui tam action which obtains
46 proceeds shall be entitled to receive between twenty-five and thirty
47 percent of the proceeds recovered in the action or settlement of the
48 action. The court shall determine the percentage of the proceeds to
49 which a person commencing a qui tam civil action is entitled, by consid-
50 ering the extent to which the plaintiff substantially contributed to the
51 prosecution of the action.
52 (c) With the exception of a court award of costs, expenses or attor-
53 neys' fees, any payment to a person pursuant to this paragraph shall be
54 made from the proceeds.
55 7. Costs, expenses, disbursements and attorneys' fees. In any action
56 brought pursuant to this article, the court may award the attorney
S. 2108--C 139 A. 4308--C
1 general, on behalf of the people of the state of New York, and any local
2 government that participates as a party in the action, and any person
3 who is a qui tam plaintiff, an amount for reasonable expenses which the
4 court finds to have been necessarily incurred, plus reasonable attor-
5 neys' fees, plus costs pursuant to article eighty-one of the civil prac-
6 tice law and rules. All such expenses, fees and costs shall be awarded
7 directly against the defendant and shall not be charged from the
8 proceeds, but shall only be awarded if the state or a local government
9 or the qui tam civil action plaintiff prevails in the action.
10 8. Exclusion from recovery. If the court finds that the qui tam civil
11 action was brought by a person who planned or initiated the violation of
12 section one hundred eighty-nine of this article upon which the action
13 was brought, then the court may, to the extent the court considers
14 appropriate, reduce the share of the proceeds of the action which the
15 person would otherwise be entitled to receive under subdivision six of
16 this section, taking into account the role of such person in advancing
17 the case to litigation and any relevant circumstances pertaining to the
18 violation. If the person bringing the qui tam civil action is convicted
19 of criminal conduct arising from his or her role in the violation of
20 section one hundred eighty-nine of this article, that person shall be
21 dismissed from the qui tam civil action and shall not receive any share
22 of the proceeds of the action. Such dismissal shall not prejudice the
23 right of the attorney general to supersede or intervene in such action
24 and to civilly prosecute the same on behalf of the state or a local
25 government.
26 9. Certain actions barred. No court shall have jurisdiction over a qui
27 tam civil action brought pursuant to subdivision two of this section:
28 (a) based on allegations or transactions which are the subject of a
29 pending civil action or an administrative action in which the state or a
30 local government is already a party;
31 (b) derived from public disclosure of allegations or transactions in a
32 criminal, civil, or administrative hearing, in a legislative or adminis-
33 trative report, hearing, audit or investigation, or from the news media,
34 unless the person who initiated the action is an original source of the
35 information;
36 (c) if the agency has reached a binding settlement or other agreement
37 with the person who submitted such false claims resolving the matter and
38 such agreement has been approved in writing by the attorney general, or
39 by the local government attorney if the matter involves allegations of
40 false claims submitted to a local government; or
41 (d) against a member of the legislature, a member of the judiciary, or
42 a senior executive branch official if the action is based on evidence or
43 information known to the state when the action was brought.
44 10. Liability. Neither the state nor any local government shall be
45 liable for any expenses which any person incurs in bringing a qui tam
46 civil action under this article.
47 § 191. Remedies of employees. 1. Any employee of any private or public
48 employer who is discharged, demoted, suspended, threatened, harassed or
49 in any other manner discriminated against in the terms and conditions of
50 employment by his or her employer because of lawful acts done by the
51 employee on behalf of the employer or others in furtherance of an action
52 brought under this article, including the investigation for, initiation
53 of, testimony for, or assistance in an action filed or to be filed under
54 this section, shall be entitled to all relief necessary to make the
55 employee whole. Such relief shall include but not be limited to:
56 (a) an injunction to restrain continued discrimination;
S. 2108--C 140 A. 4308--C
1 (b) reinstatement to the position such employee would have had but for
2 the discrimination or to an equivalent position;
3 (c) reinstatement of full fringe benefits and seniority rights;
4 (d) payment of two times back pay, plus interest; and
5 (e) compensation for any special damages sustained as a result of the
6 discrimination, including litigation costs and reasonable attorneys'
7 fees.
8 2. An employee described in subdivision one of this section may bring
9 an action in the appropriate supreme court for the relief provided in
10 this section.
11 § 192. Limitation of actions, burden of proof. 1. A civil action under
12 this article shall be commenced no later than:
13 (a) six years after the date on which the violation of section one
14 hundred eighty-nine of this article is committed; or
15 (b) three years after the date when facts material to the right of
16 action are known or reasonably should have been known by the official of
17 the state or local government charged with responsibility to act in the
18 circumstances, but in no event more than ten years after the date on
19 which the violation is committed, whichever occurs last. Notwithstand-
20 ing any other provision of law, for the purposes of this article, an
21 action under this article is commenced by the filing of the complaint in
22 the supreme court.
23 2. In any action brought under this article, the state, a local
24 government that participates as a party in the action, or the person
25 bringing the qui tam civil action, shall be required to prove all essen-
26 tial elements of the cause of action, including damages, by a preponder-
27 ance of the evidence.
28 § 193. Other law enforcement authority and duties. This article shall
29 not:
30 1. preempt the authority, or relieve the duty, of other law enforce-
31 ment agencies to investigate and prosecute suspected violations of law;
32 2. prevent or prohibit a person from voluntarily disclosing any infor-
33 mation concerning a violation of this article to any law enforcement
34 agency; or
35 3. limit any of the powers granted elsewhere in this chapter and other
36 laws to the attorney general or state agencies or local governments to
37 investigate possible violations of this article and take appropriate
38 action against wrongdoers.
39 § 194. Regulations. The attorney general is authorized to adopt such
40 rules and regulations as is necessary to effectuate the purposes of this
41 article.
42 § 40. Intentionally omitted.
43 § 40-a. Intentionally omitted.
44 § 41. Intentionally omitted.
45 § 42. Paragraph (b) of subdivision 2 of section 110-a of the workers'
46 compensation law, as added by chapter 545 of the laws of 1998, is
47 amended to read as follows:
48 (b) officers or employees of another governmental unit, or agents
49 and/or contractors of the governmental unit at the request and/or direc-
50 tion of the governmental unit, if the information sought to be disclosed
51 is necessary for the receiving governmental unit to operate a program or
52 carry out a purpose specifically authorized by statute, including the
53 investigation of a fraud, criminal offense or licensing or regulatory
54 violation, or to act upon an application for benefits submitted by the
55 person who is the subject of the record;
S. 2108--C 141 A. 4308--C
1 § 43. Paragraph 3 of subsection (e) of section 697 of the tax law, as
2 amended by chapter 6 of the laws of 2007, is amended to read as follows:
3 (3) Nothing herein shall be construed to prohibit the department, its
4 officers or employees from furnishing information to the office of
5 temporary and disability assistance relating to the payment of the cred-
6 it for certain household and dependent care services necessary for gain-
7 ful employment under subsection (c) of section six hundred six of this
8 article and the earned income credit under subsection (d) of section six
9 hundred six of this article, or pursuant to a local law enacted by a
10 city having a population of one million or more pursuant to subsection
11 (f) of section thirteen hundred ten of this chapter, only to the extent
12 necessary to calculate qualified state expenditures under paragraph
13 seven of subdivision (a) of section four hundred nine of the federal
14 social security act or to document the proper expenditure of federal
15 temporary assistance for needy families funds under section four hundred
16 three of such act. The office of temporary and disability assistance may
17 redisclose such information to the United States department of health
18 and human services only to the extent necessary to calculate such quali-
19 fied state expenditures or to document the proper expenditure of such
20 federal temporary assistance for needy families funds. Nothing herein
21 shall be construed to prohibit the delivery by the commissioner to a
22 commissioner of jurors, appointed pursuant to section five hundred four
23 of the judiciary law, or, in counties within cities having a population
24 of one million or more, to the county clerk of such county, of a mailing
25 list of individuals to whom income tax forms are mailed by the commis-
26 sioner for the sole purpose of compiling a list of prospective jurors as
27 provided in article sixteen of the judiciary law. Provided, however,
28 such delivery shall only be made pursuant to an order of the chief
29 administrator of the courts, appointed pursuant to section two hundred
30 ten of the judiciary law. No such order may be issued unless such chief
31 administrator is satisfied that such mailing list is needed to compile a
32 proper list of prospective jurors for the county for which such order is
33 sought and that, in view of the responsibilities imposed by the various
34 laws of the state on the department, it is reasonable to require the
35 commissioner to furnish such list. Such order shall provide that such
36 list shall be used for the sole purpose of compiling a list of prospec-
37 tive jurors and that such commissioner of jurors, or such county clerk,
38 shall take all necessary steps to insure that the list is kept confiden-
39 tial and that there is no unauthorized use or disclosure of such list.
40 Furthermore, nothing herein shall be construed to prohibit the delivery
41 to a taxpayer or his or her duly authorized representative of a certi-
42 fied copy of any return or report filed in connection with his or her
43 tax or to prohibit the publication of statistics so classified as to
44 prevent the identification of particular reports or returns and the
45 items thereof, or the inspection by the attorney general or other legal
46 representatives of the state of the report or return of any taxpayer or
47 of any employer filed under section one hundred seventy-one-h of this
48 chapter, where such taxpayer or employer shall bring action to set aside
49 or review the tax based thereon, or against whom an action or proceeding
50 under this chapter or under this chapter and article eighteen of the
51 labor law has been recommended by the commissioner, the commissioner of
52 labor with respect to unemployment insurance matters, or the attorney
53 general or has been instituted, or the inspection of the reports or
54 returns required under this article by the comptroller or duly desig-
55 nated officer or employee of the state department of audit and control,
56 for purposes of the audit of a refund of any tax paid by a taxpayer
S. 2108--C 142 A. 4308--C
1 under this article, or the furnishing to the state department of labor
2 of unemployment insurance information obtained or derived from quarterly
3 combined withholding, wage reporting and unemployment insurance returns
4 required to be filed by employers pursuant to paragraph four of
5 subsection (a) of section six hundred seventy-four of this article, for
6 purposes of administration of such department's unemployment insurance
7 program, employment services program, federal and state employment and
8 training programs, employment statistics and labor market information
9 programs, worker protection programs, federal programs for which the
10 department has administrative responsibility or for other purposes
11 deemed appropriate by the commissioner of labor consistent with the
12 provisions of the labor law, and redisclosure of such information in
13 accordance with the provisions of sections five hundred thirty-six and
14 five hundred thirty-seven of the labor law or any other applicable law,
15 or the furnishing to the state office of temporary and disability
16 assistance of information obtained or derived from New York state
17 personal income tax returns as described in paragraph (b) of subdivision
18 two of section one hundred seventy-one-g of this chapter for the purpose
19 of reviewing support orders enforced pursuant to title six-A of article
20 three of the social services law to aid in the determination of whether
21 such orders should be adjusted, or the furnishing of information
22 obtained from the reports required to be submitted by employers regard-
23 ing newly hired or re-hired employees pursuant to section one hundred
24 seventy-one-h of this chapter to the state office of temporary and disa-
25 bility assistance, the state department of health, the state department
26 of labor and the workers' compensation board for purposes of adminis-
27 tration of the child support enforcement program, verification of indi-
28 viduals' eligibility for one or more of the programs specified in
29 subsection (b) of section eleven hundred thirty-seven of the federal
30 social security act and for other public assistance programs authorized
31 by state law, and administration of the state's employment security and
32 workers' compensation programs, and to the national directory of new
33 hires established pursuant to section four hundred fifty-three-A of the
34 federal social security act for the purposes specified in such section,
35 or the furnishing to the state office of temporary and disability
36 assistance of the amount of an overpayment of income tax and interest
37 thereon certified to the comptroller to be credited against past-due
38 support pursuant to section one hundred seventy-one-c of this chapter
39 and of the name and social security number of the taxpayer who made such
40 overpayment, or the disclosing to the commissioner of finance of the
41 city of New York, pursuant to section one hundred seventy-one-l of this
42 chapter, of the amount of an overpayment and interest thereon certified
43 to the comptroller to be credited against a city of New York tax warrant
44 judgment debt and of the name and social security number of the taxpayer
45 who made such overpayment, or the furnishing to the New York state high-
46 er education services corporation of the amount of an overpayment of
47 income tax and interest thereon certified to the comptroller to be cred-
48 ited against the amount of a default in repayment of a guaranteed
49 student loan pursuant to section one hundred seventy-one-d of this chap-
50 ter and of the name and social security number of the taxpayer who made
51 such overpayment, or the furnishing to the state department of health of
52 the information required by subdivision two-a of section two thousand
53 five hundred eleven of the public health law, or the furnishing to the
54 state university of New York or the city university of New York respec-
55 tively or the attorney general on behalf of such state or city universi-
56 ty the amount of an overpayment of income tax and interest thereon
S. 2108--C 143 A. 4308--C
1 certified to the comptroller to be credited against the amount of a
2 default in repayment of a state university loan pursuant to section one
3 hundred seventy-one-e of this chapter and of the name and social securi-
4 ty number of the taxpayer who made such overpayment, or the disclosing
5 to a state agency, pursuant to section one hundred seventy-one-f of this
6 chapter, of the amount of an overpayment and interest thereon certified
7 to the comptroller to be credited against a past-due legally enforceable
8 debt owed to such agency and of the name and social security number of
9 the taxpayer who made such overpayment, or the furnishing of employee
10 and employer information obtained through the wage reporting system,
11 pursuant to section one hundred seventy-one-a of this chapter, as added
12 by chapter five hundred forty-five of the laws of nineteen hundred
13 seventy-eight, to the state office of temporary and disability assist-
14 ance, the department of health or to the state office of the medicaid
15 inspector general for the purpose of verifying eligibility for and enti-
16 tlement to amounts of benefits under the social services law or similar
17 law of another jurisdiction, locating absent parents or other persons
18 legally responsible for the support of applicants for or recipients of
19 public assistance and care under the social services law and persons
20 legally responsible for the support of a recipient of services under
21 section one hundred eleven-g of the social services law and, in appro-
22 priate cases, establishing support obligations pursuant to the social
23 services law and the family court act or similar provision of law of
24 another jurisdiction for the purpose of evaluating the effect on earn-
25 ings of participation in employment, training or other programs designed
26 to promote self-sufficiency authorized pursuant to the social services
27 law by current recipients of public assistance and care and by former
28 applicants and recipients of public assistance and care, (except that
29 with regard to former recipients, information which relates to a partic-
30 ular former recipient shall be provided with client identifying data
31 deleted), and to the state department of labor, or other individuals
32 designated by the commissioner of labor, for the purpose of the adminis-
33 tration of such department's unemployment insurance program, employment
34 services program, federal and state employment and training programs,
35 employment statistics and labor market information programs, worker
36 protection programs, federal programs for which the department has
37 administrative responsibility or for other purposes deemed appropriate
38 by the commissioner of labor consistent with the provisions of the labor
39 law, and redisclosure of such information in accordance with the
40 provisions of sections five hundred thirty-six and five hundred thirty-
41 seven of the labor law, or the furnishing of information, which is
42 obtained from the wage reporting system operated pursuant to section one
43 hundred seventy-one-a of this chapter, as added by chapter five hundred
44 forty-five of the laws of nineteen hundred seventy-eight, to the state
45 office of temporary and disability assistance so that it may furnish
46 such information to public agencies of other jurisdictions with which
47 the state office of temporary and disability assistance has an agreement
48 pursuant to paragraph (h) or (i) of subdivision three of section twenty
49 of the social services law, and to the state office of temporary and
50 disability assistance for the purpose of fulfilling obligations and
51 responsibilities otherwise incumbent upon the state department of labor,
52 under section one hundred twenty-four of the federal family support act
53 of nineteen hundred eighty-eight, by giving the federal parent locator
54 service, maintained by the federal department of health and human
55 services, prompt access to such information as required by such act, or
56 to the state department of health to establish eligibility under the
S. 2108--C 144 A. 4308--C
1 child health insurance plan pursuant to subdivision two-a of section two
2 thousand five hundred eleven of the public health law and to verify
3 eligibility for the program for elderly pharmaceutical insurance cover-
4 age under title three of article two of the elder law, or to the office
5 of vocational and educational services for individuals with disabilities
6 of the education department, the commission for the blind and visually
7 handicapped and any other state vocational rehabilitation agency, for
8 purposes of obtaining reimbursement from the federal social security
9 administration for expenditures made by such office, commission or agen-
10 cy on behalf of disabled individuals who have achieved economic self-
11 sufficiency or to the higher education services corporation for the
12 purpose of assisting the corporation in default prevention and default
13 collection of federal guaranteed student loans through the federal fami-
14 ly education loan program as codified in chapter twenty-eight of title
15 twenty of the United States code; provided, however, that such informa-
16 tion shall be limited to the names, social security numbers, home and/or
17 business addresses, and employer names of defaulted or delinquent
18 student loan borrowers.
19 Provided, however, that with respect to employee information the
20 office of temporary and disability assistance shall only be furnished
21 with the names, social security account numbers and gross wages of those
22 employees who are (A) applicants for or recipients of benefits under the
23 social services law, or similar provision of law of another jurisdiction
24 (pursuant to an agreement under subdivision three of section twenty of
25 the social services law) or, (B) absent parents or other persons legally
26 responsible for the support of applicants for or recipients of public
27 assistance and care under the social services law or similar provision
28 of law of another jurisdiction (pursuant to an agreement under subdivi-
29 sion three of section twenty of the social services law), or (C) persons
30 legally responsible for the support of a recipient of services under
31 section one hundred eleven-g of the social services law or similar
32 provision of law of another jurisdiction (pursuant to an agreement under
33 subdivision three of section twenty of the social services law), or (D)
34 employees about whom wage reporting system information is being
35 furnished to public agencies of other jurisdictions, with which the
36 state office of temporary and disability assistance has an agreement
37 pursuant to paragraph (h) or (i) of subdivision three of section twenty
38 of the social services law, or (E) employees about whom wage reporting
39 system information is being furnished to the federal parent locator
40 service, maintained by the federal department of health and human
41 services, for the purpose of enabling the state office of temporary and
42 disability assistance to fulfill obligations and responsibilities other-
43 wise incumbent upon the state department of labor, under section one
44 hundred twenty-four of the federal family support act of nineteen
45 hundred eighty-eight, and, only if, the office of temporary and disabil-
46 ity assistance certifies to the commissioner that such persons are such
47 applicants, recipients, absent parents or persons legally responsible
48 for support or persons about whom information has been requested by a
49 public agency of another jurisdiction or by the federal parent locator
50 service and further certifies that in the case of information requested
51 under agreements with other jurisdictions entered into pursuant to
52 subdivision three of section twenty of the social services law, that
53 such request is in compliance with any applicable federal law. Provided,
54 further, that where the office of temporary and disability assistance
55 requests employee information for the purpose of evaluating the effects
56 on earnings of participation in employment, training or other programs
S. 2108--C 145 A. 4308--C
1 designed to promote self-sufficiency authorized pursuant to the social
2 services law, the office of temporary and disability assistance shall
3 only be furnished with the quarterly gross wages (excluding any refer-
4 ence to the name, social security number or any other information which
5 could be used to identify any employee or the name or identification
6 number of any employer) paid to employees who are former applicants for
7 or recipients of public assistance and care and who are so certified to
8 the commissioner by the commissioner of the office of temporary and
9 disability assistance. Provided, further, that with respect to employee
10 information, the department of health shall only be furnished with the
11 information required pursuant to subdivision two-a of section two thou-
12 sand five hundred eleven of the public health law with respect to those
13 children whose eligibility under the child health insurance plan is to
14 be determined pursuant to such subdivision two-a and with respect to
15 those members of any such child's household whose income affects such
16 child's eligibility and who are so certified to the commissioner or by
17 the department of health. Provided, further, that wage reporting infor-
18 mation shall be furnished to the office of vocational and educational
19 services for individuals with disabilities of the education department,
20 the commission for the blind and visually handicapped and any other
21 state vocational rehabilitation agency only if such office, commission
22 or agency, as applicable, certifies to the commissioner that such infor-
23 mation is necessary to obtain reimbursement from the federal social
24 security administration for expenditures made on behalf of disabled
25 individuals who have achieved self-sufficiency. Reports and returns
26 shall be preserved for three years and thereafter until the commissioner
27 orders them to be destroyed.
28 § 44. Subdivision 3 of section 363-d of the social services law, as
29 added by chapter 442 of the laws of 2006, is amended to read as follows:
30 3. Upon enrollment in the medical assistance program, a provider shall
31 certify to the department that the provider satisfactorily meets the
32 requirements of this section. Additionally, the commissioner of health
33 and Medicaid inspector general shall have the authority to determine at
34 any time if a provider has a compliance program that satisfactorily
35 meets the requirements of this section.
36 (a) A compliance program that is accepted by the federal department of
37 health and human services office of inspector general and remains in
38 compliance with the standards promulgated by such office shall be deemed
39 in compliance with the provisions of this section, so long as such plans
40 adequately address medical assistance program risk areas and compliance
41 issues.
42 (b) In the event that the commissioner of health or the Medicaid
43 inspector general finds that the provider does not have a satisfactory
44 program within ninety days after the effective date of the regulations
45 issued pursuant to subdivision four of this section, the provider may be
46 subject to any sanctions or penalties permitted by federal or state laws
47 and regulations, including revocation of the provider's agreement to
48 participate in the medical assistance program.
49 § 45. Subdivision 1 of section 33 of the public health law, as added
50 by chapter 442 of the laws of 2006, is amended to read as follows:
51 1. In addition to the authority otherwise provided by this title, the
52 inspector, in carrying out the provisions of this title, is authorized
53 to request such information, assistance and cooperation from any feder-
54 al, state or local governmental department, board, bureau, commission,
55 or other agency or unit thereof as may be necessary for carrying out the
56 duties and responsibilities enjoined upon the inspector by this section.
S. 2108--C 146 A. 4308--C
1 State and local agencies or units thereof are hereby authorized and
2 directed to provide to the inspector, or, at the request of the inspec-
3 tor, to state agencies or their contractors, such information, assist-
4 ance and cooperation. Notwithstanding any other provision of law to the
5 contrary, requests for information, assistance and cooperation may
6 include, but not be limited to, all state and local government birth,
7 death and vital statistics which may be contained in files, databases or
8 registries, and for all information shall, upon request, include, where
9 possible, making electronic copies or record exchanges available. Execu-
10 tive agencies shall coordinate and facilitate the transfer of appropri-
11 ate functions and positions to the office as necessary and in accordance
12 with applicable law.
13 § 46. Intentionally omitted.
14 § 47. Intentionally omitted.
15 § 48. Intentionally omitted.
16 § 49. Intentionally omitted.
17 § 50. Intentionally omitted.
18 § 51. Subdivision 4 of section 145-b of the social services law, as
19 amended by chapter 2 of the laws of 1998, is amended to read as follows:
20 4. (a) The department of health may require the payment of a monetary
21 penalty as restitution to the medical assistance program by any person
22 who fails to comply with the standards of the medical assistance program
23 or of generally accepted medical practice in a substantial number of
24 cases or grossly and flagrantly violated such standards and receives, or
25 causes to be received by another person, payment from the medical
26 assistance program when such person knew, or had reason to know, that:
27 (i) the payment involved the providing or ordering of care, services
28 or supplies that were medically improper, unnecessary or in excess of
29 the documented medical needs of the person to whom they were furnished;
30 (ii) the care, services or supplies were not provided as claimed;
31 (iii) the person who ordered or prescribed care, services or supplies
32 which was medically improper, unnecessary or in excess of the documented
33 medical need of the person to whom they were furnished was suspended or
34 excluded from the medical assistance program at the time the care,
35 services or supplies were furnished; or
36 (iv) the services or supplies for which payment was received were not,
37 in fact, provided.
38 (b) [Such penalty shall be in lieu of requiring a person to refund or
39 repay all or part of any payment from the medical assistance program
40 received by such person or caused to be received by another person as a
41 result of a violation of the terms of this subdivision.] For each claim,
42 the department of health is authorized to recover any overpayment, unau-
43 thorized payment, or otherwise inappropriate payment and if twenty-five
44 percent or more of those claims which were the subject of an audit by
45 the department of health result in overpayments, unauthorized payments
46 or otherwise inappropriate payments and for which the claims were
47 submitted by a person for payment under the medical assistance program,
48 the department may also impose a monetary penalty against any person, or
49 persons, who received the overpayment, unauthorized payment, or other-
50 wise inappropriate payment for such claim. If less than twenty-five
51 percent of identified claims result in overpayments, unauthorized
52 payments or otherwise inappropriate payments then the department of
53 health may recover such monies or may impose a monetary penalty, but not
54 both. In addition, the department of health is also authorized to
55 recover any overpayment, unauthorized payment, or otherwise inappropri-
56 ate payment and impose a monetary penalty against any person, or
S. 2108--C 147 A. 4308--C
1 persons, other than a recipient of an item or service under the medical
2 assistance program, who caused the overpayment, unauthorized payment, or
3 otherwise inappropriate payment to be received by the other person or
4 persons. All of the foregoing actions may be taken by the department of
5 health for the same claim. In determining the amount of any monetary
6 penalty to be imposed, the department of health must take into consider-
7 ation the following: (i) the number and total value of the claims for
8 payment from the medical assistance program which were the underlying
9 basis of the determination to impose a monetary penalty; (ii) the
10 effect, if any, on the quality of medical care provided to recipients of
11 medical assistance as a result of the acts of the person; (iii) the
12 degree of culpability of the person in committing the proscribed actions
13 and any mitigating circumstances; (iv) any prior violations committed by
14 the person relating to the medical assistance program, Medicare or other
15 social services programs which resulted in either a criminal or adminis-
16 trative sanction, penalty, or recoupment; and (v) any other facts relat-
17 ing to the nature and seriousness of the violations including any excul-
18 patory facts. However, in no event can the department of health recover
19 overpayments, unauthorized payments, or otherwise inappropriate payments
20 from any person, or persons, for a single claim, in an amount that
21 exceeds the amount paid for such claim. In no event shall the monetary
22 penalty imposed exceed [two] ten thousand dollars for each item or
23 service which was the subject of the determination herein, except that
24 where a penalty under this section has been imposed on a person within
25 the previous five years, such penalty shall not exceed [seven] thirty
26 thousand [five hundred] dollars for each item or service which was the
27 subject of the determination herein.
28 (c) Amounts collected pursuant to this subdivision shall be appor-
29 tioned between the local social services district and the state in
30 accordance with the regulations of the department of health.
31 § 52. Intentionally omitted.
32 § 53. Intentionally omitted.
33 § 54. Intentionally omitted.
34 § 55. Intentionally omitted.
35 § 56. Section 2808 of the public health law is amended by adding a new
36 subdivision 17-a to read as follows:
37 17-a. Notwithstanding any inconsistent provision of law or regulation
38 to the contrary, for purposes of establishing rates of payment by
39 governmental agencies for residential health care facilities for
40 services provided on and after January first, nineteen hundred ninety-
41 eight, the regional direct and indirect input price adjustment factors
42 to be applied to any such facility's rate calculation shall be based
43 upon the utilization of either nineteen hundred eighty-three, nineteen
44 hundred eighty-seven or nineteen hundred ninety-three calendar year
45 financial and statistical data and for periods beginning April first,
46 two thousand four through December thirty-first, two thousand eight
47 based on either nineteen hundred eighty-three, nineteen hundred eighty-
48 seven, nineteen hundred ninety-three or two thousand one calendar year
49 financial and statistical data; provided, however, the state share
50 amount for the utilization of two thousand one calendar year data shall
51 be no more than twenty-two million dollars on a pro rata basis per
52 calendar year. The determination of which calendar year's data to
53 utilize shall be based upon a methodology that ensures that the partic-
54 ular year chosen by each facility results in a factor that yields no
55 less reimbursement to the facility than would result from the use of any
56 of the other three years' data. Such methodology shall utilize the nine-
S. 2108--C 148 A. 4308--C
1 teen hundred eighty-three and nineteen hundred eighty-seven regional
2 direct and indirect input price adjustment factor corridor percentages
3 in existence on January first, nineteen hundred ninety-seven as well as
4 nineteen hundred ninety-three regional direct and indirect input price
5 adjustment factor corridor percentage in existence on January first, two
6 thousand four as well as a two thousand one regional direct and indirect
7 input price adjustment factor corridor percentage calculated in the same
8 manner as the nineteen hundred ninety-three direct and indirect input
9 price adjustment factor corridor percentages in existence on January
10 first, two thousand four; provided, however, for rate periods on and
11 after January first, two thousand nine, the regional input price adjust-
12 ment factors shall be based on the case mix predicted staffing for
13 registered nurses, licensed practical nurses, nurses' aides, licensed
14 therapists and therapist aides. For the rate period beginning January
15 first, two thousand nine through December thirty-first, two thousand
16 nine, the regional direct and indirect input price adjustment factors to
17 be applied to a facility's rate calculation shall be based upon the
18 utilization of two thousand two calendar year financial and statistical
19 data. Such methodology shall utilize two thousand two regional direct
20 and indirect input price adjustment factor corridor percentages calcu-
21 lated in the same manner as the two thousand one regional direct and
22 indirect input price adjustment factor corridor percentages in existence
23 on December thirty-first, two thousand six except that every region
24 shall receive a corridor to reflect the region's actual variation with-
25 out regard to any maximum statewide average variable corridor percent-
26 age. For the rate periods beginning January first, two thousand ten
27 through December thirty-first, two thousand eleven, the regional direct
28 and indirect input price adjustment factors to be applied to a facili-
29 ty's rate calculation shall be based upon the utilization of two thou-
30 sand eight calendar year financial and statistical data. Such methodol-
31 ogy shall utilize two thousand eight regional direct and indirect input
32 price adjustment factor corridor percentages calculated in the same
33 manner as the two thousand two regional direct and indirect input price
34 adjustment factor corridor percentages, with every region receiving a
35 corridor to reflect the region's actual variation without regard to any
36 maximum statewide average variable corridor percentage. For the three
37 year period beginning January first, two thousand twelve, the regional
38 direct price and indirect input price adjustment factors and the
39 regional direct and indirect input price adjustment factor corridor
40 percentages shall be based upon the utilization of financial and statis-
41 tical data from the base period used for the operating component of
42 rates for the two thousand twelve rate period pursuant to paragraph (f)
43 of subdivision two-b of this section.
44 § 57. Subdivision 4 of section 366-c of the social services law, as
45 added by chapter 558 of the laws of 1989, is amended to read as follows:
46 4. In determining the amount of income to be applied toward the cost
47 of medical care, services and supplies of the institutionalized spouse,
48 after the institutionalized spouse has been determined eligible for
49 medical assistance, the following items shall be deducted from the
50 monthly income of the institutionalized spouse in the following order:
51 (a) a personal needs allowance;
52 (b) a community spouse monthly income allowance;
53 (c) a family allowance for each family member;
54 (d) any expenses incurred for medical care, services or supplies and
55 remedial care for the institutionalized spouse;
S. 2108--C 149 A. 4308--C
1 provided, however, that, to the extent required by federal law, the
2 terms of this subdivision shall not apply to persons who are receiving
3 care, services and supplies pursuant to the nursing facility transition
4 and diversion waiver under section 1915(c) of the federal social securi-
5 ty act and authorized pursuant to subdivision six-a of section three
6 hundred sixty-six of this title.
7 § 58. Paragraph (b) of subdivision 2 of section 367-a of the social
8 services law, as added by chapter 319 of the laws of 1981, is amended to
9 read as follows:
10 (b) Any inconsistent provision of this chapter or other law notwith-
11 standing, upon furnishing assistance under this title to any applicant
12 or recipient of medical assistance, the local social services district
13 or the department shall be subrogated, to the extent of the expenditures
14 by such district or department for medical care furnished, to any rights
15 such person may have to medical support or third party reimbursement.
16 For purposes of this section, the term medical support shall mean the
17 right to support specified as support for the purpose of medical care by
18 a court or administrative order. The right of subrogation does not
19 attach to insurance benefits paid or provided under any health insurance
20 policy prior to the receipt of written notice of the exercise of subro-
21 gation rights by the carrier issuing such insurance, nor shall such
22 right of subrogation attach to any benefits which may be claimed by a
23 social services official or the department, by agreement or other estab-
24 lished procedure, directly from an insurance carrier. No right of subro-
25 gation to insurance benefits available under any health insurance policy
26 shall be enforceable unless written notice of the exercise of such
27 subrogation right is received by the carrier within [two] three years
28 from the date services for which benefits are provided under the policy
29 or contract are rendered. The local social services district or the
30 department shall also notify the carrier when the exercise of subroga-
31 tion rights has terminated because a person is no longer receiving
32 assistance under this title. Such carrier shall establish mechanisms to
33 maintain the confidentiality of all individually identifiable informa-
34 tion or records. Such carrier shall limit the use of such information or
35 record to the specific purpose for which such disclosure is made, and
36 shall not further disclose such information or records.
37 § 59. Intentionally omitted.
38 § 60. Intentionally omitted
39 § 61. Paragraph (f) of subdivision 4 of section 365-a of the social
40 services law, as added by section 21-a of part C of chapter 109 of the
41 laws of 2006, is amended to read as follows:
42 [(f)] (g) for eligible persons who are also beneficiaries under part D
43 of title XVIII of the federal social security act, drugs which are
44 denominated as "covered part D drugs" under section 1860D-2(e) of such
45 act; provided however that, for purposes of this paragraph, "covered
46 part D drugs" shall not mean atypical anti-psychotics, anti-depressants,
47 anti-retrovirals used in the treatment of HIV/AIDS, or anti-rejection
48 drugs used for the treatment of organ and tissue transplants.
49 § 62. Paragraph (f) of section 1 of part C of chapter 58 of the laws
50 of 2005, amending the public health law and other laws relating to
51 authorizing reimbursements for expenditures made by social services
52 districts for medical assistance, is amended to read as follows:
53 (f) Subject to paragraph (g) of this section, the state fiscal year
54 social services district expenditure cap amount calculated for each
55 social services district pursuant to paragraph (d) of this section shall
56 be allotted to each district during that fiscal year and paid to the
S. 2108--C 150 A. 4308--C
1 department in equal weekly amounts in a manner to be determined by the
2 commissioner and communicated to such districts and shall represent each
3 district's maximum responsibility for medical assistance expenditures
4 governed by this section. [Commencing January 1, 2008, all such amounts
5 shall be deposited into the general fund of the state treasury to the
6 credit of the state purposes account therein.]
7 § 63. Subparagraph 7 of paragraph (a) of subdivision 2 of section 366
8 of the social services law, as amended by chapter 938 of the laws of
9 1990, the opening paragraph as amended by chapter 12 of the laws of
10 2005, is amended to read as follows:
11 (7) income in an amount set forth in the following schedule and
12 provisions, provided, however, that federal financial participation is
13 available for the disregard of the amount of such annual income for any
14 household [may not exceed] exceeding one hundred thirty-three and one-
15 third percent of the highest income standard used to determine eligibil-
16 ity under subparagraph eight of paragraph (a) of subdivision one of this
17 section for a household of the same size:
18 Annual net income - Number of family members in the medical assistance
19 household, as defined in regulations by the commissioner consistent with
20 federal regulations under title XIX of the federal social security act.
21 Three Four Five Six Seven Eight
22 $8,500 $10,200 $11,900 $13,600 $15,300 $17,000
23 The amounts for one and two person households and families shall be
24 equal to twelve times the standard of monthly need for determining
25 eligibility for and the amount of additional state payments for aged,
26 blind and disabled persons pursuant to section two hundred nine of this
27 chapter rounded up to the next highest one hundred dollars for eligible
28 individuals and couples living alone, respectively, and, for households
29 of three or more the above schedule shall be adjusted upward if neces-
30 sary to maintain at least a one hundred dollar differential among house-
31 hold and family sizes and increased by seventeen hundred dollars for
32 each member of a family in excess of eight.
33 No other income or resources, including federal old-age, survivors and
34 disability insurance, state disability insurance or other payroll
35 deductions, whether mandatory or optional, shall be exempt and all other
36 income and resources shall be taken into consideration and required to
37 be applied toward the payment or partial payment of the cost of medical
38 care and services available under this title, to the extent permitted by
39 federal law.
40 § 63-a. Subdivision 12 of section 367-a of the social services law, as
41 added by section 64 of part A of chapter 1 of the laws of 2002, is
42 amended to read as follows:
43 12. Prior to receiving medical assistance under subparagraphs twelve
44 and thirteen of paragraph (a) of subdivision one of section three
45 hundred sixty-six of this title, a person whose net available income is
46 at least one hundred fifty percent of the applicable federal income
47 official poverty line, as defined and updated by the United States
48 department of health and human services, must pay a monthly premium, in
49 accordance with a procedure to be established by the commissioner. The
50 amount of such premium shall be [equal to the sum of three percent of
51 the person's net earned income and seven and one-half percent of the
52 person's net unearned income] twenty-five dollars for an individual who
53 is otherwise eligible for medical assistance under such subparagraphs,
54 and fifty dollars for a couple, both of whom are otherwise eligible for
55 medical assistance under such subparagraphs. No premium shall be
56 required from a person whose net available income is less than one
S. 2108--C 151 A. 4308--C
1 hundred fifty percent of the applicable federal income official poverty
2 line, as defined and updated by the United States department of health
3 and human services.
4 § 63-b. Section 3614 of the public health law is amended by adding a
5 new subdivision 3-c to read as follows:
6 3-c. Home telehealth. (a) Demonstration rates of payment or fees shall
7 be established for telehealth services provided by a certified home
8 health agency, a long term home health care program or AIDS home care
9 program, or for telehealth services by a licensed home care services
10 agency under contract with such an agency or program, in order to ensure
11 the availability of technology-based patient monitoring, communication
12 and health management. Reimbursement for telehealth services provided
13 pursuant to this section shall be provided only in connection with
14 Federal Food and Drug Administration-approved and interoperable devices,
15 and incorporated as part of the patient's plan of care. The commission-
16 er shall seek federal financial participation with regard to this demon-
17 stration initiative.
18 (b) The purposes of such services shall be to assist in the effective
19 monitoring and management of patients whose medical, functional and/or
20 environmental needs can be appropriately and cost-effectively met at
21 home through the application of telehealth intervention. Reimbursement
22 provided pursuant to this subdivision shall be for services to patients
23 with conditions or clinical circumstances associated with the need for
24 frequent monitoring, and/or the need for frequent physician, skilled
25 nursing or acute care services, and where the provision of telehealth
26 services can appropriately reduce the need for on-site or in-office
27 visits or acute or long term care facility admissions. Such conditions
28 and clinical circumstances shall include, but not be limited to, conges-
29 tive heart failure, diabetes, chronic pulmonary obstructive disease,
30 wound care, polypharmacy, mental or behavioral problems limiting self-
31 management, and technology-dependent care such as continuous oxygen,
32 ventilator care, total parenteral nutrition or enteral feeding.
33 (c) Demonstration rates or fees established by the commissioner and
34 approved by the director of the budget, for such telehealth services
35 shall reflect telehealth services costs on a monthly basis in order to
36 account for daily variation in the intensity and complexity of patients'
37 telehealth service needs; provided that such demonstration rates shall
38 further reflect the cost of the daily operation and provision of such
39 services, which costs shall include the following functions undertaken
40 by the participating certified home health agency, long term home health
41 care program, AIDS home care program or licensed home care services
42 agency:
43 (i) Monitoring of patient vital signs;
44 (ii) Patient education;
45 (iii) Medication management;
46 (iv) Equipment maintenance;
47 (v) Review of patient trends and/or other changes in patient condition
48 necessitating professional intervention; and
49 (vi) Such other activities as the commissioner may deem necessary and
50 appropriate to this section.
51 (d) The commissioner shall take such additional steps as may be
52 reasonably necessary to implement the provision of this subdivision;
53 provided however that the commissioner shall establish initial demon-
54 stration rates or fees for telehealth services as provided for in this
55 subdivision by no later than October first, two thousand seven; and
56 provided, further, however, that the commissioner shall seek the input
S. 2108--C 152 A. 4308--C
1 of representatives from participating providers and other interested
2 parties in the development of such rates or fees and any applicable
3 requirements established pursuant to this subdivision.
4 § 63-c. The social services law is amended by adding a new section
5 367-u to read as follows:
6 § 367-u. Payment for home telehealth services. Subject to the approval
7 of the state director of the budget, the commissioner may authorize the
8 payment of medical assistance funds for demonstration rates or fees
9 established for home telehealth services provided pursuant to subdivi-
10 sion three-c of section thirty-six hundred fourteen of the public health
11 law.
12 § 63-d. Section 364-j-2 of the social services law, as amended by
13 chapter 12 of the laws of 2005 and subdivisions 2 and 5 as amended by
14 section 53-a of part C of chapter 109 of the laws of 2006, is amended to
15 read as follows:
16 § 364-j-2. Transitional supplemental payments. 1. As used in this
17 section, "covered provider" shall mean a voluntary not-for-profit health
18 care provider that is any of the following:
19 (a) a freestanding diagnostic and treatment center licensed under
20 article twenty-eight of the public health law that qualifies for a
21 distribution pursuant to section twenty-eight hundred seven-p of such
22 article, or section seven of chapter four hundred thirty-three of the
23 laws of nineteen hundred ninety-seven, or receives funding under section
24 three hundred thirty-three of the federal public health services act for
25 health care for the homeless; or
26 (b) a freestanding diagnostic and treatment center which operates an
27 approved program under the prenatal care assistance program established
28 pursuant to article twenty-five of the public health law; or
29 (c) a facility licensed under article twenty-eight of the public
30 health law that is sponsored by a university or dental school which has
31 been granted an operating certificate pursuant to article twenty-eight
32 of the public health law to provide dental services; or
33 (d) a freestanding family planning clinic licensed under article twen-
34 ty-eight of the public health law.
35 2. (a) Notwithstanding paragraphs (b) and (h) of subdivision two of
36 section twenty-eight hundred seven of the public health law, the commis-
37 sioner of health shall make supplemental payments of nine million eight
38 hundred twenty-four thousand dollars ($9,824,000), to covered providers
39 described in subdivision one of this section who are qualified providers
40 as described in paragraph (a) of subdivision three of this section,
41 based on adjustments to fee-for-service rates for the period February
42 first through March thirty-first, two thousand two and nine million
43 eight hundred twenty-four thousand dollars ($9,824,000) for the period
44 October first through December thirty-first, two thousand two and four
45 million nine hundred twelve thousand dollars ($4,912,000) for the period
46 October first through December thirty-first, two thousand three and an
47 additional amount of four million nine hundred twelve thousand dollars
48 ($4,912,000) for the period October first through December thirty-first,
49 two thousand three and nine million eight hundred twenty-four thousand
50 dollars ($9,824,000) for the period April first through June thirtieth,
51 two thousand five, and nine million eight hundred twenty-four thousand
52 dollars ($9,824,000) for the period October first through December thir-
53 ty-first, two thousand six, and an additional nine million eight hundred
54 twenty-four thousand dollars ($9,824,000) for the period October first
55 through December thirty-first, two thousand six, and nine million eight
56 hundred twenty-four thousand dollars ($9,824,000) for the period October
S. 2108--C 153 A. 4308--C
1 first through December thirty-five, two thousand seven, as medical
2 assistance payments for services provided pursuant to this title for
3 persons eligible for federal financial participation under title XIX of
4 the federal social security act to reflect additional costs associated
5 with the transition to a managed care environment. There shall be no
6 local share in these payments. The director of the budget shall allocate
7 the non-federal share of such payments from an appropriation for the
8 miscellaneous special revenue fund - 339 community service provider
9 assistance program account for the two thousand one--two thousand two
10 state fiscal year for adjustments for the period February first through
11 March thirty-first, two thousand two. Adjustments for the period October
12 first, two thousand two through December thirty-first, two thousand two
13 shall be within amounts appropriated for the two thousand two--two thou-
14 sand three state fiscal year and adjustments for the period October
15 first, two thousand three through December thirty-first, two thousand
16 three shall be within amounts appropriated for the two thousand three--
17 two thousand four state fiscal year and adjustments for the non-federal
18 share of the additional amount of four million nine hundred twelve thou-
19 sand dollars ($4,912,000) for such period shall be allocated by the
20 director of the budget from an appropriation for maintenance undistrib-
21 uted general fund community projects fund - 007 account for the two
22 thousand three--two thousand four state fiscal year. The director of the
23 budget shall allocate the non-federal share of adjustments for the peri-
24 od April first, two thousand five through June thirtieth, two thousand
25 five from an appropriation for the maintenance undistributed general
26 fund community projects fund - 007 - cc account for the two thousand
27 four--two thousand five state fiscal year. The director of the budget
28 shall allocate the non-federal share of adjustments for the period Octo-
29 ber first, two thousand six through December thirty-first, two thousand
30 six from an appropriation for the maintenance undistributed, general
31 fund, community projects fund - 007-cc account for the two thousand
32 five--two thousand six state fiscal year. The director of the budget
33 shall allocate the non-federal share of the additional adjustments for
34 the period October first, two thousand six through December thirty-
35 first, two thousand six from such funds as may be made available from an
36 appropriation for the maintenance undistributed, general fund, community
37 projects fund - 007-cc account for the two thousand six--two thousand
38 seven state fiscal year. the director of the budget shall allocate the
39 non-federal share of the adjustments for the period October first, two
40 thousand seven through December thirty-first two thousand seven from an
41 appropriation for the medical assistance program, general fund, local
42 assistance account - 001 for the two thousand seven--two thousand eight
43 state fiscal year. Such adjustments to fee for service rates shall not
44 be subject to subsequent adjustment or reconciliation. Alternatively,
45 such payments may be made as aggregate payments to eligible providers.
46 (a-1) Notwithstanding the provisions of paragraph (a) of this subdivi-
47 sion, for facilities licensed under article twenty-eight of the public
48 health law that are sponsored by a university or dental school which has
49 been granted an operating certificate pursuant to article twenty-eight
50 of the public health law and which provides dental services as its prin-
51 cipal mission, two hundred twenty-four thousand dollars ($224,000) in
52 the aggregate for use pursuant to this section shall be allocated for
53 distribution to such facilities pursuant to the methodology described in
54 paragraph (b) of subdivision two and subparagraph (i) of paragraph (b)
55 of subdivision four of section two thousand eight hundred seven-p of the
56 public health law for services provided for the period February first,
S. 2108--C 154 A. 4308--C
1 two thousand two through March thirty-first, two thousand two to persons
2 eligible for federal financial participation under title XIX of the
3 federal social security act, provided, however, that the amount paid
4 pursuant to this paragraph for each such facility shall equal the facil-
5 ity's proportional share of the total nominal payment amounts calculated
6 under this section of all such facilities multiplied by the total funds
7 allocated for such payments. There shall be no local share in these
8 payments. The director of the budget shall allocate the non-federal
9 share of such payments from an appropriation for the miscellaneous
10 special revenue fund - 339 community service provider assistance program
11 account for the two thousand one--two thousand two state fiscal year.
12 Such adjustments to fee for service rates shall not be subject to subse-
13 quent adjustment or reconciliation. Alternatively, such payments may be
14 made as aggregate payments to eligible providers.
15 (a-2) (i) Notwithstanding the provisions of paragraph (a) of this
16 subdivision, for facilities licensed under article twenty-eight of the
17 public health law that are sponsored by a university or dental school
18 which has been granted an operating certificate pursuant to article
19 twenty-eight of the public health law and which provides dental services
20 as its principal mission, two hundred twenty-four thousand dollars
21 ($224,000) in the aggregate of the amount appropriated for the two thou-
22 sand two--two thousand three state fiscal year for use pursuant to this
23 section shall be allocated for the period October first through December
24 thirty-first, two thousand two and one hundred twelve thousand dollars
25 ($112,000) in the aggregate of the amount appropriated for the two thou-
26 sand three--two thousand four state fiscal year, and an additional
27 amount of one hundred twelve thousand dollars ($112,000) in the aggre-
28 gate for use pursuant to this section shall be allocated for the period
29 October first through December thirty-first, two thousand three and two
30 hundred twenty-four thousand dollars ($224,000) in the aggregate of the
31 amount appropriated for the two thousand four--two thousand five state
32 fiscal year shall be allocated for the period April first, two thousand
33 five through June thirtieth, two thousand five, and two hundred twenty-
34 four thousand dollars ($224,000) in the aggregate of the amount appro-
35 priated for the two thousand five--two thousand six state fiscal year
36 shall be allocated for the period October first, two thousand six
37 through December thirty-first, two thousand six, and an additional two
38 hundred twenty-four thousand dollars ($224,000) in the aggregate of the
39 amount appropriated for the two thousand six--two thousand seven state
40 fiscal year shall be allocated for the period October first, two thou-
41 sand six through December thirty-first, two thousand six, and two
42 hundred twenty-four thousand dollars ($224,000) in the aggregate of the
43 amount appropriated for the two thousand seven--two thousand eight state
44 fiscal year shall be allocated for the period October first, two thou-
45 sand seven through December thirty-first, two thousand seven for
46 distribution to such facilities pursuant to subparagraphs (ii) and (iii)
47 of this paragraph. Adjustments for the non-federal share of the addi-
48 tional amount of one hundred twelve thousand dollars ($112,000) for the
49 period October first, two thousand three through December thirty-first,
50 two thousand three shall be allocated by the director of the budget from
51 an appropriation for maintenance undistributed general fund community
52 projects fund - 007 account for the two thousand three--two thousand
53 four state fiscal year. The non-federal share of adjustments for the
54 period April first, two thousand five through June thirtieth, two thou-
55 sand five shall be allocated by the director of the budget from an
56 appropriation for the maintenance undistributed general fund community
S. 2108--C 155 A. 4308--C
1 projects fund - 007 account for the two thousand four--two thousand five
2 state fiscal year. The non-federal share of adjustments for the period
3 October first, two thousand six through December thirty-first, two thou-
4 sand six shall be allocated by the director of the budget from an appro-
5 priation for the maintenance undistributed, general fund, community
6 projects fund - 007-cc account for the two thousand five--two thousand
7 six state fiscal year. The non-federal share of the additional adjust-
8 ments for the period October first, two thousand six through December
9 thirty-first, two thousand six shall, subject to the availability of
10 funds, be allocated by the director of the budget from the medical
11 assistance local assistance appropriation for the two thousand six--two
12 thousand seven state fiscal year. The non-federal share of the adjust-
13 ments for the period October first, two thousand seven through December
14 thirty-first, two thousand seven shall be allocated by the director of
15 the budget from an appropriation for the medical assistance program,
16 general fund, local assistance account - 001 for the two thousand
17 seven--two thousand eight state fiscal year.
18 (ii) Forty percent shall be allocated for equal distribution to such
19 facilities, reduced by the amount, if any, that a distribution exceeds
20 forty percent of a facility's uncompensated care need as defined in
21 paragraph (b) of subdivision two of section two thousand eight hundred
22 seven-p of the public health law. Any funds allocated but not distrib-
23 uted in accordance with this subparagraph shall be added to those
24 amounts distributed in accordance with subparagraph (iii) of this para-
25 graph.
26 (iii) Sixty percent, plus any funds allocated and not distributed in
27 accordance with subparagraph (ii) of this paragraph, shall be allocated
28 for distribution to such facilities pursuant to the methodology
29 described in paragraph (b) of subdivision two and subparagraph (i) of
30 paragraph (b) of subdivision four of section two thousand eight hundred
31 seven-p of the public health law, provided, however, that the amount
32 paid pursuant to this allocation for each such facility shall equal the
33 facility's proportional share of the total nominal payment amounts
34 calculated under this section of all such facilities multiplied by the
35 total funds allocated for such payments.
36 (iv) There shall be no local share in these payments.
37 (b) Notwithstanding the provisions of subdivision one of section three
38 hundred sixty-eight-a of this title, there shall be paid to each social
39 services district the full amount expended on behalf of the department
40 of health for medical assistance furnished pursuant to the provisions of
41 this section, after first deducting therefrom any federal funds properly
42 received or to be received on account thereof.
43 3. (a) A covered provider described in subdivision one of this section
44 shall be qualified to receive a supplemental payment only if its number
45 of medicaid visits for patient care services in the base year described
46 in subparagraph (ii) of paragraph (b) of this subdivision equals or
47 exceeds twenty-five percent of its total number of visits for patient
48 care services and its number of medicaid visits for patient care
49 services for medicaid managed care enrollees equals or exceeds three
50 percent of its total number of medicaid visits during the base year.
51 (b) (i) Each qualified provider described in paragraph (a) of this
52 subdivision shall receive a supplemental payment equal to such provid-
53 er's proportional share of the total funds allocated pursuant to this
54 section, based upon the ratio of its visits from medical assistance
55 recipients enrolled in managed care during the base year to the total
S. 2108--C 156 A. 4308--C
1 number of visits to all such qualified providers by medical assistance
2 recipients enrolled in managed care during the base year.
3 (ii) For purposes of the calculation described in this subdivision,
4 the base year will be two thousand, and the commissioner of health shall
5 utilize data as reported on the 2000 AHCF-1 cost report initially
6 submitted by covered providers to the department of health on or about
7 August seventeenth, two thousand one.
8 4. Payments made pursuant to this section shall constitute additional
9 reimbursement to qualified providers and shall not be used to reduce
10 levels of other funding provided to qualified providers by governmental
11 agencies.
12 5. (a) The commissioner of health shall make medical assistance
13 payments to qualified providers from funds made available pursuant to
14 the provisions of this section contingent upon the receipt of all feder-
15 al approvals necessary and subject to the availability of federal finan-
16 cial participation under title XIX of the federal social security act
17 for the transitional supplemental payments. In the event such federal
18 approval is not received prior to March thirty-first, two thousand two,
19 for adjustments for the period February first, two thousand two through
20 March thirty-first, two thousand two and prior to October first, two
21 thousand two for adjustments for the period October first, two thousand
22 two through December thirty-first, two thousand two and prior to October
23 first, two thousand three for adjustments for the period October first,
24 two thousand three through December thirty-first, two thousand three,
25 and prior to October first, two thousand five for adjustments for the
26 period April first, two thousand five through June thirtieth, two thou-
27 sand five, and prior to October first, two thousand six for adjustments
28 for the period October first, two thousand six through December thirty-
29 first, two thousand six, and prior to October first, two thousand seven
30 for adjustments for the period October first, two thousand seven through
31 December thirty-first two thousand seven, the commissioner of health
32 shall make medical assistance payments to qualified providers consisting
33 of the state share amount available for purposes of this section and
34 apportioned in accordance with subdivisions two and three of this
35 section. In the event such federal approval is denied, such state share
36 amount payments shall be deemed to be grants to such qualified providers
37 and such qualified providers shall not be eligible to receive any other
38 payments pursuant to this section.
39 (b) The commissioner of health shall take all steps necessary and
40 shall use best efforts to secure federal financial participation under
41 title XIX of the social security act, for the purposes of this section,
42 including the prompt submission of appropriate amendments to the title
43 XIX state plan.
44 § 63-e. Paragraph (b) of subdivision 11 of section 3614 of the public
45 health law, as amended by section 5 of part C of chapter 109 of the laws
46 of 2006, is amended to read as follows:
47 (b) The commissioner shall increase the medical assistance rates of
48 payment pursuant to this subdivision in an amount up to an aggregate of
49 sixteen million dollars for the period June first, two thousand six
50 through March thirty-first, two thousand seven, and sixteen million
51 dollars for the period April first, two thousand seven through March
52 thirty-first, two thousand eight, provided however that if federal
53 financial participation is not available for rate adjustments pursuant
54 to this subdivision such aggregate amount shall not exceed eight million
55 dollars, and provided, further, however, that for purposes of long term
56 home health care programs, such payments provided pursuant to this
S. 2108--C 157 A. 4308--C
1 subdivision shall be treated as supplemental payments and shall not
2 effect any current cost cap requirement.
3 § 63-f. The public health law is amended by adding a new section
4 2807-n to read as follows:
5 § 2807-n. Palliative care education and training. 1. Definitions. The
6 following words or phrases as used in this section shall have the
7 following meanings:
8 (a) "Palliative care" shall mean (i) the active, interdisciplinary
9 care of patients with advanced, life limiting illness, focusing on
10 relief of distressing physical and psychosocial symptoms and meeting
11 spiritual needs. Its goal is achievement of the best quality of life for
12 patients and families as defined by paragraph (b) of subdivision two of
13 section four thousand twelve-b of this chapter; and (ii) it shall also
14 include similar care for patients with chronic or acute pain.
15 (b) "Palliative care certified medical school" shall mean a medical
16 school in the state which is an institution granting a degree of doctor
17 of medicine or doctor of osteopathic medicine in accordance with regu-
18 lations by the commissioner of education under subdivision two of
19 section sixty-five hundred twenty-four of the education law, and which
20 meets standards defined by the commissioner of health, after consulta-
21 tion with the council, pursuant to regulations, and used to determine
22 whether a medical school is eligible for funding under this section.
23 (c) "Palliative care certified residency program" shall mean a gradu-
24 ate medical education program in the state which has received accredi-
25 tation from a nationally recognized accreditation body for medical or
26 osteopathic residency programs, and which meets standards defined by the
27 commissioner, after consultation with the council, pursuant to regu-
28 lations, and used to determine whether a residency training program is
29 eligible for funding under this section.
30 (d) "New York state palliative care education and training council" or
31 "council" shall mean the New York state palliative care education and
32 training council established pursuant to subdivision six of this
33 section.
34 2. Grants for undergraduate medical education in palliative care. (a)
35 The commissioner is authorized, within amounts appropriated for such
36 purpose to make grants to palliative care certified medical schools to
37 enhance the study of palliative care, increase the opportunities for
38 undergraduate medical education in palliative care and encourage the
39 education of physicians in palliative care.
40 (b) Grant proceeds under this subdivision may be used for faculty
41 development in palliative care; recruitment of faculty with expertise in
42 palliative care; costs incurred teaching medical students at hospital-
43 based sites, non-hospital-based ambulatory care settings, palliative
44 care sites and hospices including, but not limited to, personnel, admin-
45 istration and student-related expenses; expansion or development of
46 programs that train physicians in palliative care; and other innovative
47 programs designed to increase the competency of medical students to
48 provide hospice or palliative care.
49 (c) Grants under this subdivision shall be awarded by the commissioner
50 through a competitive application process to the council. The council
51 shall make recommendations for funding to the commissioner. In making
52 awards, consideration shall be given to applicants who:
53 (i) plan to incorporate palliative care longitudinally throughout the
54 medical school curriculum according to professionally recognized stand-
55 ards including, but not limited to, a plan that covers the seven domains
56 identified in the Palliative Education Assessment Tool (PEAT) as devel-
S. 2108--C 158 A. 4308--C
1 oped by the New York Academy of Medicine and the Associated Medical
2 Schools of New York State and Weill Cornell Medical College;
3 (ii) function in collaboration with hospital-based palliative care
4 programs and non-hospital-based sites; and
5 (iii) make complementary efforts to recruit or train qualified faculty
6 in palliative care education.
7 (d) The intent of this subdivision is to augment or increase pallia-
8 tive care undergraduate medical education. Grant funding shall not be
9 used to offset existing expenditures that the medical school has obli-
10 gated or intends to obligate for palliative care education programs.
11 3. Grants for graduate medical education in palliative care. (a) The
12 commissioner is authorized, within amounts appropriated for such purpose
13 to make grants in support of palliative care certified residency educa-
14 tion programs to establish or expand education in palliative care for
15 graduate medical education, and to increase the opportunities for train-
16 ee education in palliative care in hospital-based palliative care
17 programs or non-hospital-based care sites.
18 (b) Grants under this subdivision for graduate medical education and
19 education in palliative care may be used for administration, faculty
20 recruitment and development, start-up costs and costs incurred teaching
21 palliative care in hospital-based palliative care programs or non-hospi-
22 tal-based care sites, including, but not limited to, personnel, adminis-
23 tration and trainee related expenses and other expenses judged reason-
24 able and necessary by the commissioner.
25 (c) Grants under this subdivision shall be awarded by the commissioner
26 through a competitive application process to the council. The council
27 shall make recommendations for funding to the commissioner. In making
28 awards, the commissioner shall consider the extent to which the appli-
29 cant:
30 (i) plans to incorporate palliative care longitudinally throughout the
31 residency training program according to professionally recognized stand-
32 ards including, but not limited to, a plan that covers the seven domains
33 identified in the Palliative Education Assessment Tool (PEAT) as devel-
34 oped by the New York Academy of Medicine and the Associated Medical
35 Schools of New York State and Weill Cornell Medical College;
36 (ii) functions in collaboration with hospital-based palliative care
37 programs or non-hospital-based sites, or both; and
38 (iii) makes complementary efforts to recruit or train qualified facul-
39 ty in palliative care education.
40 (d) The intent of this subdivision is to augment or increase training
41 in palliative care during residency. Grant funding shall not be used to
42 offset existing expenditures the institution or program has obligated or
43 intends to obligate for such training programs.
44 4. Centers for palliative care excellence. The commissioner shall
45 designate organizations licensed pursuant to this article and article
46 forty of this chapter, upon successful application, as centers for
47 palliative care excellence. Such designations shall be pursuant to an
48 application as designed by the department, and based on service, staff-
49 ing and other criteria as developed by the council. Such centers of
50 excellence shall provide specialized palliative care, treatment, educa-
51 tion and related services. Designation as a center for palliative care
52 excellence shall not entitle a center to enhanced reimbursement, but may
53 be utilized in outreach and other promotional activities.
54 5. Palliative care practitioner resource centers. The commissioner, in
55 consultation with the council, may designate palliative care practition-
56 er resource centers (a "resource center"). A resource center may be
S. 2108--C 159 A. 4308--C
1 statewide or regional, and shall act as a source of technical informa-
2 tion and guidance for practitioners on the latest palliative care strat-
3 egies, therapies and medications. The department, in consultation with
4 the council, may contract with not-for-profit organizations or associ-
5 ations to establish and manage resource centers. A resource center may
6 charge a fee to defray the cost of the service.
7 6. New York state palliative care education and training council. (a)
8 The New York state palliative care education and training council is
9 established in the department as an expert panel in palliative medicine,
10 education and training. Its members shall be appointed by the commis-
11 sioner. The commissioner shall seek recommendations for appointments to
12 such council from New York state-based health care professional, consum-
13 er, medical institutional and medical educational leaders. Members of
14 the council shall include: nine representatives of medical schools and
15 hospital organizations; two representatives of medical academies; two
16 patient advocates; individual representatives of an organization broadly
17 representative of physicians, internal medicine, family physicians,
18 nursing, hospice, neurology, psychiatry, pediatrics, obstetrics-gynecol-
19 ogy, surgery, and the hospital philanthropic community; and the execu-
20 tive director or a member of the governor's taskforce on life and the
21 law and of the New York state council on graduate medical education.
22 Members shall have expertise in palliative care or pain management.
23 Members shall serve a term of three years with renewable terms. Members
24 shall receive no compensation for their services, but shall be allowed
25 actual and necessary expenses in the performance of their duties.
26 (b) A chairperson and vice-chairperson of the council shall be elected
27 annually by the council. The council shall meet upon the call of the
28 chairperson, and may adopt bylaws consistent with this section.
29 (c) The commissioner shall designate such employees and provide other
30 resources of the department as are reasonably necessary to provide
31 support services to the council. The council, acting by the chair of the
32 council, may employ additional staff and consultants and incur other
33 expenses to carry out its duties, to be paid from amounts which may be
34 made available to the council for that purpose.
35 (d) The council may provide technical information and guidance for
36 practitioners on the latest palliative care strategies, therapies and
37 medications.
38 7. Reports. The commissioner, in conjunction with the council, shall
39 prepare and submit a report to the governor and the legislature, on or
40 before February first, two thousand ten reporting the results and evalu-
41 ating the effectiveness of this section.
42 § 64. Paragraph (e-1) of subdivision 12 of section 2808 of the public
43 health law, as amended by section 62 of part A of chapter 57 of the laws
44 of 2006, is amended to read as follows:
45 (e-1) Notwithstanding any inconsistent provision of law or regulation,
46 the commissioner shall provide, in addition to payments established
47 pursuant to this article prior to application of this section, addi-
48 tional payments under the medical assistance program pursuant to title
49 eleven of article five of the social services law for non-state operated
50 public residential health care facilities, including public residential
51 health care facilities located in the county of Nassau, the county of
52 Westchester and the county of Erie, but excluding public residential
53 health care facilities operated by a town or city within a county, in
54 [an] aggregate [amount] annual amounts of up to one hundred fifty
55 million dollars in additional payments for the state fiscal year begin-
56 ning April first, two thousand six and for the state fiscal year begin-
S. 2108--C 160 A. 4308--C
1 ning April first, two thousand seven and for the state fiscal year
2 beginning April first, two thousand eight and for the state fiscal year
3 beginning April first, two thousand nine. The amount allocated to each
4 eligible public residential health care facility for this period shall
5 be computed in accordance with the provisions of paragraph (f) of this
6 subdivision, provided, however, that patient days shall be utilized for
7 such computation reflecting actual reported data for two thousand three
8 and each representative succeeding year as applicable.
9 § 65. Paragraph (a) of subdivision 1 of section 212 of chapter 474 of
10 the laws of 1996, amending the education law and other laws relating to
11 rates for residential health care facilities, as amended by section 40
12 of part A of chapter 57 of the laws of 2006, is amended to read as
13 follows:
14 (a) Notwithstanding any inconsistent provision of law or regulation to
15 the contrary, effective beginning August 1, 1996, for the period April
16 1, 1997 through March 31, 1998, April 1, 1998 for the period April 1,
17 1998 through March 31, 1999, August 1, 1999, for the period April 1,
18 1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
19 through March 31, 2001, April 1, 2001, for the period April 1, 2001
20 through March 31, 2002, April 1, 2002, for the period April 1, 2002
21 through March 31, 2003, and for the state fiscal year beginning April 1,
22 2005 through March 31, 2006, and for the state fiscal year beginning
23 April 1, 2006 through March 31, 2007, and for the state fiscal year
24 beginning April 1, 2007 through March 31, 2008, and for the state fiscal
25 year beginning April 1, 2008 through March 31, 2009, the department of
26 health is authorized to pay public general hospitals, as defined in
27 subdivision 10 of section 2801 of the public health law, operated by the
28 state of New York or by the state university of New York or by a county,
29 which shall not include a city with a population of over one million, of
30 the state of New York, and those public general hospitals located in the
31 county of Westchester, the county of Erie or the county of Nassau, addi-
32 tional payments for inpatient hospital services as medical assistance
33 payments pursuant to title 11 of article 5 of the social services law
34 for patients eligible for federal financial participation under title
35 XIX of the federal social security act in medical assistance pursuant to
36 the federal laws and regulations governing disproportionate share
37 payments to hospitals up to one hundred percent of each such public
38 general hospital's medical assistance and uninsured patient losses after
39 all other medical assistance, including disproportionate share payments
40 to such public general hospital for 1996, 1997, 1998, and 1999, based
41 initially for 1996 on reported 1994 reconciled data as further recon-
42 ciled to actual reported 1996 reconciled data, and for 1997 based
43 initially on reported 1995 reconciled data as further reconciled to
44 actual reported 1997 reconciled data, for 1998 based initially on
45 reported 1995 reconciled data as further reconciled to actual reported
46 1998 reconciled data, for 1999 based initially on reported 1995 recon-
47 ciled data as further reconciled to actual reported 1999 reconciled
48 data, for 2000 based initially on reported 1995 reconciled data as
49 further reconciled to actual reported 2000 data, for 2001 based initial-
50 ly on reported 1995 reconciled data as further reconciled to actual
51 reported 2001 data, for 2002 based initially on reported 2000 reconciled
52 data as further reconciled to actual reported 2002 data, and for state
53 fiscal years beginning on April 1, 2005, based initially on reported
54 2000 reconciled data as further reconciled to actual reported data for
55 2005, and for state fiscal years beginning on April 1, 2006, based
56 initially on reported 2000 reconciled data as further reconciled to
S. 2108--C 161 A. 4308--C
1 actual reported data for 2006 and for state fiscal years beginning on
2 and after April 1, 2007, based initially on reported 2000 reconciled
3 data as further reconciled to actual reported data for 2007, and to
4 actual reported data for each respective succeeding year. The payments
5 may be added to rates of payment or made as aggregate payments to an
6 eligible public general hospital.
7 § 66. Paragraph (b) of subdivision 1 of section 211 of chapter 474 of
8 the laws of 1996, amending the education law and other laws relating to
9 rates for residential health care facilities, as amended by section 41
10 of part A of chapter 57 of the laws of 2006, is amended to read as
11 follows:
12 (b) Notwithstanding any inconsistent provision of law or regulation to
13 the contrary, effective beginning April 1, 2000, the department of
14 health is authorized to pay public general hospitals, other than those
15 operated by the state of New York or the state university of New York,
16 as defined in subdivision 10 of section 2801 of the public health law,
17 located in a city with a population of over 1 million, additional
18 initial payments for inpatient hospital services of $120 million during
19 each state fiscal year until March 31, 2003, and up to $120 million
20 during the state fiscal year beginning April 1, 2005 through March 31,
21 2006 and during the state fiscal year beginning April 1, 2006 through
22 March 31, 2007 and during the state fiscal year beginning April 1, 2007
23 through March 31, 2008 and during the state fiscal year beginning April
24 1, 2008 through March 31, 2009, as medical assistance payments pursuant
25 to title 11 of article 5 of the social services law for patients eligi-
26 ble for federal financial participation under title XIX of the federal
27 social security act in medical assistance pursuant to the federal laws
28 and regulations governing disproportionate share payments to hospitals
29 based on the relative share of each such non-state operated public
30 general hospital of medical assistance and uninsured patient losses
31 after all other medical assistance, including disproportionate share
32 payments to such public general hospitals for payments made during the
33 state fiscal year ending March 31, 2001, based initially on reported
34 1995 reconciled data as further reconciled to actual reported 2000 or
35 2001 data, for payments made during the state fiscal year ending March
36 31, 2002, based initially on reported 1995 reconciled data as further
37 reconciled to actual reported 2001 or 2002 data, for payments made
38 during the state fiscal year ending March 31, 2003, based initially on
39 reported 2000 reconciled data as further reconciled to actual reported
40 2002 or 2003 data, for payments made during the state fiscal [years]
41 year ending on and after March 31, 2006, based initially on reported
42 2000 reconciled data as further reconciled to actual reported 2005 or
43 2006 data, for payments made during the state fiscal [years] year ending
44 on and after March 31, 2007, based initially on reported 2000 reconciled
45 data as further reconciled to actual reported 2006 or 2007 data for
46 payments made during the state fiscal years ending on and after March
47 31, 2008, based initially on reported 2000 reconciled data as further
48 reconciled to actual reported 2007 or 2008 data, and to actual reported
49 data for each respective succeeding year. The payments may be added to
50 rates of payment or made as aggregate payments to an eligible public
51 general hospital.
52 § 67. Subdivision 12 of section 246 of chapter 81 of the laws of 1995,
53 amending the public health law and other laws relating to medical
54 reimbursement and welfare reform, as amended by section 67-a of part C
55 of chapter 58 of the laws of 2005, is amended to read as follows:
S. 2108--C 162 A. 4308--C
1 12. Sections one hundred five-b through one hundred five-f of this act
2 shall expire March 31, [2007] 2008.
3 § 68. Section 11 of chapter 884 of the laws of 1990, amending the
4 public health law relating to authorizing bad debt and charity care
5 allowances for certified home health agencies, as amended by chapter 146
6 of the laws of 2006, is amended to read as follows:
7 § 11. This act shall take effect immediately and:
8 (a) sections one and three shall expire on December 31, 1996,
9 (b) sections four through ten shall expire on June 30, [2007] 2009,
10 and
11 (c) provided that the amendment to section 2807-b of the public health
12 law by section two of this act shall not affect the expiration of such
13 section 2807-b as otherwise provided by law and shall be deemed to
14 expire therewith.
15 § 69. Subdivisions 2 and 4 of section 246 of chapter 81 of the laws of
16 1995, amending the public health law and other laws relating to medical
17 reimbursement and welfare reform, as amended by section 69 of part A of
18 chapter 57 of the laws of 2006, are amended to read as follows:
19 2. Sections five, seven through nine, twelve through fourteen, and
20 eighteen of this act shall be deemed to have been in full force and
21 effect on and after April 1, 1995 through March 31, 1999 and on and
22 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
23 through March 31, 2003 and on and after April 1, 2003 through March 31,
24 2006 and on and after April 1, 2006 through March 31, 2007 and on and
25 after April 1, 2007 through March 31, 2009;
26 4. Section one of this act shall be deemed to have been in full force
27 and effect on and after April 1, 1995 through March 31, 1999 and on and
28 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
29 through March 31, 2003 and on and after April 1, 2003 through March 31,
30 2006 and on and after April 1, 2006 through March 31, 2007 and on and
31 after April 1, 2007 through March 31, 2009.
32 § 70. Subparagraph (iii) of paragraph (f) of subdivision 4 of section
33 2807-c of the public health law, as amended by section 70 of part A of
34 chapter 57 of the laws of 2006, is amended to read as follows:
35 (iii) commencing April first, nineteen hundred ninety-seven through
36 March thirty-first, nineteen hundred ninety-nine and commencing July
37 first, nineteen hundred ninety-nine through March thirty-first, two
38 thousand and April first, two thousand through March thirty-first, two
39 thousand five and for periods commencing April first, two thousand five
40 through March thirty-first, two thousand six and for periods commencing
41 on and after April first, two thousand six through March thirty-first,
42 two thousand seven and for periods commencing on and after April first,
43 two thousand seven through March thirty-first, two thousand nine, the
44 reimbursable inpatient operating cost component of case based rates of
45 payment per diagnosis-related group, excluding any operating cost compo-
46 nents related to direct and indirect expenses of graduate medical educa-
47 tion, for patients eligible for payments made by state governmental
48 agencies shall be reduced by three and thirty-three hundredths percent
49 to encourage improved productivity and efficiency. Such election shall
50 not alter the calculation of the group price component calculated pursu-
51 ant to subparagraph (i) of paragraph (a) of subdivision seven of this
52 section;
53 § 71. Subparagraph (iii) of paragraph (k) of subdivision 4 of section
54 2807-c of the public health law, as amended by section 71 of part A of
55 chapter 57 of the laws of 2006, is amended to read as follows:
S. 2108--C 163 A. 4308--C
1 (iii) commencing April first, nineteen hundred ninety-seven through
2 March thirty-first, nineteen hundred ninety-nine and commencing July
3 first, nineteen hundred ninety-nine through March thirty-first, two
4 thousand and April first, two thousand through March thirty-first, two
5 thousand five and commencing April first, two thousand five through
6 March thirty-first, two thousand six, and for periods commencing on and
7 after April first, two thousand six through March thirty-first, two
8 thousand seven, and for periods commencing on and after April first, two
9 thousand seven through March thirty-first, two thousand nine, the oper-
10 ating cost component of rates of payment, excluding any operating cost
11 components related to direct and indirect expenses of graduate medical
12 education, for patients eligible for payments made by a state govern-
13 mental agency shall be reduced by three and thirty-three hundredths
14 percent to encourage improved productivity and efficiency. The facility
15 will be eligible to receive the financial incentives for the physician
16 specialty weighting incentive towards primary care pursuant to subpara-
17 graph (ii) of paragraph (a) of subdivision twenty-five of this section.
18 § 72. The opening paragraph of subparagraph (vi) of paragraph (b) of
19 subdivision 5 of section 2807-c of the public health law, as amended by
20 section 72 of part A of chapter 57 of the laws of 2006, is amended to
21 read as follows:
22 for discharges on or after April first, nineteen hundred ninety-seven
23 through March thirty-first, nineteen hundred ninety-nine and for
24 discharges on or after July first, nineteen hundred ninety-nine through
25 March thirty-first, two thousand and for discharges on or after April
26 first, two thousand through March thirty-first, two thousand five and
27 for discharges on or after April first, two thousand five through March
28 thirty-first, two thousand six, and for discharges on or after April
29 first, two thousand six through March thirty-first, two thousand seven,
30 and for discharges on or after April first, two thousand seven through
31 March thirty-first, two thousand nine, for purposes of reimbursement of
32 inpatient hospital services for patients eligible for payments made by
33 state governmental agencies, the average reimbursable inpatient operat-
34 ing cost per discharge of a general hospital shall, to encourage
35 improved productivity and efficiency, be the sum of:
36 § 73. The opening paragraph and subparagraph (i) of paragraph (c) of
37 subdivision 5 of section 2807-c of the public health law, as amended by
38 section 73 of part A of chapter 57 of the laws of 2006, are amended to
39 read as follows:
40 Notwithstanding any inconsistent provision of this section, commencing
41 July first, nineteen hundred ninety-six through March thirty-first,
42 nineteen hundred ninety-nine and July first, nineteen hundred ninety-
43 nine through March thirty-first, two thousand and April first, two thou-
44 sand through March thirty-first, two thousand five and for periods on
45 and after April first, two thousand five through March thirty-first, two
46 thousand six, and for periods on and after April first, two thousand six
47 through March thirty-first, two thousand seven, and for periods on and
48 after April first, two thousand seven through March thirty-first, two
49 thousand nine, rates of payment for a general hospital for patients
50 eligible for payments made by state governmental agencies shall be
51 further reduced by the commissioner to encourage improved productivity
52 and efficiency by providers by a factor determined as follows:
53 (i) an aggregate reduction shall be calculated for each general hospi-
54 tal commencing July first, nineteen hundred ninety-six through March
55 thirty-first, nineteen hundred ninety-nine and July first, nineteen
56 hundred ninety-nine through March thirty-first, two thousand and April
S. 2108--C 164 A. 4308--C
1 first, two thousand through March thirty-first, two thousand five and
2 for periods on and after April first, two thousand five through March
3 thirty-first, two thousand six, and for periods on and after April
4 first, two thousand six through March thirty-first, two thousand seven,
5 and for periods on and after April first, two thousand seven through
6 March thirty-first, two thousand nine, as the result of (A) eighty-nine
7 million dollars on an annualized basis for each year, multiplied by (B)
8 the ratio of patient days for patients eligible for payments made by
9 state governmental agencies provided in a base year two years prior to
10 the rate year by a general hospital, divided by the total of such
11 patient days summed for all general hospitals; and
12 § 74. Clause (B-1) of subparagraph (i) of paragraph (f) of subdivision
13 11 of section 2807-c of the public health law, as amended by section 74
14 of part A of chapter 57 of the laws of 2006, is amended to read as
15 follows:
16 (B-1) The increase in the statewide average case mix in the periods
17 January first, nineteen hundred ninety-seven through March thirty-first,
18 two thousand and on and after April first, two thousand through March
19 thirty-first, two thousand six and on and after April first, two thou-
20 sand six through March thirty-first, two thousand seven, and on and
21 after April first, two thousand seven through March thirty-first, two
22 thousand nine, from the statewide average case mix for the period Janu-
23 ary first, nineteen hundred ninety-six through December thirty-first,
24 nineteen hundred ninety-six shall not exceed one percent for nineteen
25 hundred ninety-seven, two percent for nineteen hundred ninety-eight,
26 three percent for the period January first, nineteen hundred ninety-nine
27 through September thirtieth, nineteen hundred ninety-nine, four percent
28 for the period October first, nineteen hundred ninety-nine through
29 December thirty-first, nineteen hundred ninety-nine, and four percent
30 for two thousand plus an additional one percent per year thereafter,
31 based on comparison of data only for patients that are eligible for
32 medical assistance pursuant to title eleven of article five of the
33 social services law, including such patients enrolled in health mainte-
34 nance organizations.
35 § 75. Subdivision 1 of section 46 of chapter 639 of the laws of 1996
36 amending the public health law and other laws relating to welfare
37 reform, as amended by section 75 of part A of chapter 57 of the laws of
38 2006, is amended to read as follows:
39 1. Notwithstanding any inconsistent provision of law or regulation to
40 the contrary, the trend factors used to project reimbursable operating
41 costs to the rate period for purposes of determining rates of payment
42 pursuant to article 28 of the public health law for general hospitals
43 for reimbursement of inpatient hospital services provided to patients
44 eligible for payments made by state governmental agencies on and after
45 April 1, 1996 through June 30, 1996 and on or after July 1, 1996 through
46 March 31, 1999 and on and after July 1, 1999 through March 31, 2000 and
47 on and after April 1, 2000 through March 31, 2005 and on and after April
48 1, 2005 through March 31, 2006 and on and after April 1, 2006 through
49 March 31, 2007 and on and after April 1, 2007 through March 31, 2009,
50 shall reflect no trend factor projections or adjustments for the period
51 April 1, 1996, through March 31, 1997.
52 § 76. Section 4 of chapter 81 of the laws of 1995, amending the public
53 health law and other laws relating to medical reimbursement and welfare
54 reform, as amended by section 76 of part A of chapter 57 of the laws of
55 2006, is amended to read as follows:
S. 2108--C 165 A. 4308--C
1 § 4. Notwithstanding any inconsistent provision of law, except subdi-
2 vision 15 of section 2807 of the public health law and section 364-j-2
3 of the social services law and section 32-g of part F of chapter 412 of
4 the laws of 1999, rates of payment for diagnostic and treatment centers
5 established in accordance with paragraphs (b) and (h) of subdivision 2
6 of section 2807 of the public health law for the period ending September
7 30, 1995 shall continue in effect through September 30, 2000 and for the
8 periods October 1, 2000 through September 30, 2003 and October 1, 2003
9 through September 30, 2007 and October 1, 2007 through September 30,
10 2009, and further provided that rates in effect on March 31, 2003 as
11 established in accordance with paragraph (e) of subdivision 2 of section
12 2807 of the public health law shall continue in effect for the period
13 April 1, 2003 through September 30, 2007 and October 1, 2007 through
14 September 30, 2009, provided however that, subject to the approval of
15 the director of the budget, such rates may be adjusted to include
16 expenditures in those components of rates not subject to the ceilings of
17 the corresponding rate methodology.
18 § 77. Subdivision 5 of section 246 of chapter 81 of the laws of 1995,
19 amending the public health law and other laws relating to medical
20 reimbursement and welfare reform, as amended by section 77 of part A of
21 chapter 57 of the laws of 2006, is amended to read as follows:
22 5. Section three of this act shall be deemed to have been in full
23 force and effect on and after April 1, 1995 through March 31, 1999 and
24 on and after July 1, 1999 through March 31, 2000 and on and after April
25 1, 2000 through March 31, 2003 and on and after April 1, 2003 through
26 March 31, 2007 and on and after April 1, 2007 through March 31, 2009;
27 § 78. Section 194 of chapter 474 of the laws of 1996, amending the
28 education law and other laws relating to rates for residential health
29 care facilities, as amended by section 78 of part A of chapter 57 of the
30 laws of 2006, is amended to read as follows:
31 § 194. 1. Notwithstanding any inconsistent provision of law or regu-
32 lation, the trend factors used to project reimbursable operating costs
33 to the rate period for purposes of determining rates of payment pursuant
34 to article 28 of the public health law for residential health care
35 facilities for reimbursement of inpatient services provided to patients
36 eligible for payments made by state governmental agencies on and after
37 April 1, 1996 through March 31, 1999 and for payments made on and after
38 July 1, 1999 through March 31, 2000 and on and after April 1, 2000
39 through March 31, 2003 and on and after April 1, 2003 through March 31,
40 2007 and on and after April 1, 2007 through March 31, 2009 shall reflect
41 no trend factor projections or adjustments for the period April 1, 1996,
42 through March 31, 1997.
43 2. The commissioner of health shall adjust such rates of payment to
44 reflect the exclusion pursuant to this section of such specified trend
45 factor projections or adjustments.
46 § 79. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of
47 the laws of 1995, amending the public health law and other laws relating
48 to medical reimbursement and welfare reform, as amended by section 82 of
49 part A of chapter 57 of the laws of 2006, is amended to read as follows:
50 (f) Prior to February 1, 2001, February 1, 2002, February 1, 2003,
51 February 1, 2004, February 1, 2005, February 1, 2006, [and] February 1,
52 2007, February 1, 2008 and February 1, 2009 the commissioner of health
53 shall calculate the result of the statewide total of residential health
54 care facility days of care provided to beneficiaries of title XVIII of
55 the federal social security act (medicare), divided by the sum of such
56 days of care plus days of care provided to residents eligible for
S. 2108--C 166 A. 4308--C
1 payments pursuant to title 11 of article 5 of the social services law
2 minus the number of days provided to residents receiving hospice care,
3 expressed as a percentage, for the period commencing January 1, through
4 November 30, of the prior year respectively, based on such data for such
5 period. This value shall be called the 2000, 2001, 2002, 2003, 2004,
6 2005, 2006 [and], 2007, 2008 and 2009 statewide target percentage
7 respectively.
8 § 80. Subparagraph (ii) of paragraph (b) of subdivision 3 of section
9 64 of chapter 81 of the laws of 1995, amending the public health law and
10 other laws relating to medical reimbursement and welfare reform, as
11 amended by section 83 of part A of chapter 57 of the laws of 2006, is
12 amended to read as follows:
13 (ii) If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
14 [and] 2007, 2008 and 2009 statewide target percentages are not for each
15 year at least three percentage points higher than the statewide base
16 percentage, the commissioner of health shall determine the percentage by
17 which the statewide target percentage for each year is not at least
18 three percentage points higher than the statewide base percentage. The
19 percentage calculated pursuant to this paragraph shall be called the
20 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and] 2007, 2008
21 and 2009 statewide reduction percentage respectively. If the 1997, 1998,
22 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and] 2007, 2008 and 2009
23 statewide target percentage for the respective year is at least three
24 percentage points higher than the statewide base percentage, the state-
25 wide reduction percentage for the respective year shall be zero.
26 § 81. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
27 64 of chapter 81 of the laws of 1995, amending the public health law and
28 other laws relating to medical reimbursement and welfare reform, as
29 amended by section 84 of part A of chapter 57 of the laws of 2006, is
30 amended to read as follows:
31 (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and] 2007,
32 2008 and 2009 statewide reduction percentage shall be multiplied by one
33 hundred two million dollars respectively to determine the 1998, 2000,
34 2001, 2002, 2003, 2004, 2005, 2006, [and] 2007, 2008 and 2009 statewide
35 aggregate reduction amount. If the 1998 and the 2000, 2001, 2002, 2003,
36 2004, 2005, 2006, [and] 2007, 2008 and 2009 statewide reduction percent-
37 age shall be zero respectively, there shall be no 1998, 2000, 2001,
38 2002, 2003, 2004, 2005, 2006, [and] 2007, 2008 and 2009 reduction
39 amount.
40 § 82. Paragraph (b) of subdivision 5 of section 64 of chapter 81 of
41 the laws of 1995, amending the public health law and other laws relating
42 to medical reimbursement and welfare reform, as amended by section 85 of
43 part A of chapter 57 of the laws of 2006, is amended to read as follows:
44 (b) The 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005,
45 2006, [and] 2007, 2008 and 2009 statewide aggregate reduction amounts
46 shall for each year be allocated by the commissioner of health among
47 residential health care facilities that are eligible to provide services
48 to beneficiaries of title XVIII of the federal social security act
49 (medicare) and residents eligible for payments pursuant to title 11 of
50 article 5 of the social services law on the basis of the extent of each
51 facility's failure to achieve a two percentage points increase in the
52 1996 target percentage, a three percentage point increase in the 1997,
53 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and] 2007, 2008 and
54 2009 target percentage and a two and one-quarter percentage point
55 increase in the 1999 target percentage for each year, compared to the
56 base percentage, calculated on a facility specific basis for this
S. 2108--C 167 A. 4308--C
1 purpose, compared to the statewide total of the extent of each facili-
2 ty's failure to achieve a two percentage points increase in the 1996 and
3 a three percentage point increase in the 1997 and a three percentage
4 point increase in the 1998 and a two and one-quarter percentage point
5 increase in the 1999 target percentage and a three percentage point
6 increase in the 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and] 2007,
7 2008 and 2009 target percentage compared to the base percentage. These
8 amounts shall be called the 1996, 1997, 1998, 1999, 2000, 2001, 2002,
9 2003, 2004, 2005, 2006, [and] 2007, 2008 and 2009 facility specific
10 reduction amounts respectively.
11 § 83. Notwithstanding any inconsistent provision of law, rule or regu-
12 lation, the annual percentage reductions set forth in sections seventy-
13 nine through eighty-two and section eighty-five of this act shall be
14 prorated by the commissioner of health for the period April 1, 2007
15 through March 31, 2009.
16 § 84. Section 3 of chapter 483 of the laws of 1978, amending the
17 public health law relating to rate of payment for each residential
18 health care facility to real property costs, as amended by section 87 of
19 part A of chapter 57 of the laws of 2006, is amended to read as follows:
20 § 3. This act shall take effect immediately [provided, however, that
21 the provisions of subdivision 2-a of section 2808 of the public health
22 law, as added by section one of this act, shall remain in full force and
23 effect until December 31, 2007].
24 § 85. Section 228 of chapter 474 of the laws of 1996, amending the
25 education law and other laws relating to rates for residential health-
26 care facilities, as amended by section 88 of part A of chapter 57 of the
27 laws of 2006, is amended to read as follows:
28 § 228. 1. Definitions. (a) Regions, for purposes of this section,
29 shall mean a downstate region to consist of Kings, New York, Richmond,
30 Queens, Bronx, Nassau and Suffolk counties and an upstate region to
31 consist of all other New York state counties. A certified home health
32 agency or long term home health care program shall be located in the
33 same county utilized by the commissioner of health for the establishment
34 of rates pursuant to article 36 of the public health law.
35 (b) Certified home health agency (CHHA) shall mean such term as
36 defined in section 3602 of the public health law.
37 (c) Long term home health care program (LTHHCP) shall mean such term
38 as defined in subdivision 8 of section 3602 of the public health law.
39 (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
40 ly, located within a region.
41 (e) Medicaid revenue percentage, for purposes of this section, shall
42 mean CHHA and LTHHCP revenues attributable to services provided to
43 persons eligible for payments pursuant to title 11 of article 5 of the
44 social services law divided by such revenues plus CHHA and LTHHCP reven-
45 ues attributable to services provided to beneficiaries of Title XVIII of
46 the federal social security act (medicare).
47 (f) Base period, for purposes of this section, shall mean calendar
48 year 1995.
49 (g) Target period. For purposes of this section, the 1996 target peri-
50 od shall mean August 1, 1996 through March 31, 1997, the 1997 target
51 period shall mean January 1, 1997 through November 30, 1997, the 1998
52 target period shall mean January 1, 1998 through November 30, 1998, the
53 1999 target period shall mean January 1, 1999 through November 30, 1999,
54 the 2000 target period shall mean January 1, 2000 through November 30,
55 2000, the 2001 target period shall mean January 1, 2001 through November
56 30, 2001, the 2002 target period shall mean January 1, 2002 through
S. 2108--C 168 A. 4308--C
1 November 30, 2002, the 2003 target period shall mean January 1, 2003
2 through November 30, 2003, the 2004 target period shall mean January 1,
3 2004 through November 30, 2004, and the 2005 target period shall mean
4 January 1, 2005 through November 30, 2005, the 2006 target period shall
5 mean January 1, 2006 through November 30, 2006, and the 2007 target
6 period shall mean January 1, 2007 through November 30, 2007 and the 2008
7 target period shall mean January 1, 2008 through November 30, 2008, and
8 the 2009 target period shall mean January 1, 2009 through November 30,
9 2009.
10 2. (a) Prior to February 1, 1997, for each regional group the commis-
11 sioner of health shall calculate the 1996 medicaid revenue percentages
12 for the period commencing August 1, 1996 to the last date for which such
13 data is available and reasonably accurate.
14 (b) Prior to February 1, 1998, prior to February 1, 1999, prior to
15 February 1, 2000, prior to February 1, 2001, prior to February 1, 2002,
16 prior to February 1, 2003, prior to February 1, 2004, prior to February
17 1, 2005, prior to February 1, 2006, and prior to February 1, 2007, and
18 prior to February 1, 2008 and prior to February 1, 2009 for each
19 regional group the commissioner of health shall calculate the prior
20 year's medicaid revenue percentages for the period commencing January 1
21 through November 30 of such prior year.
22 3. By September 15, 1996, for each regional group the commissioner of
23 health shall calculate the base period medicaid revenue percentage.
24 4. (a) For each regional group, the 1996 target medicaid revenue
25 percentage shall be calculated by subtracting the 1996 medicaid revenue
26 reduction percentages from the base period medicaid revenue percentages.
27 The 1996 medicaid revenue reduction percentage, taking into account
28 regional and program differences in utilization of medicaid and medicare
29 services, for the following regional groups shall be equal to:
30 (i) one and one-tenth percentage points for CHHAs located within the
31 downstate region;
32 (ii) six-tenths of one percentage point for CHHAs located within the
33 upstate region;
34 (iii) one and eight-tenths percentage points for LTHHCPs located with-
35 in the downstate region; and
36 (iv) one and seven-tenths percentage points for LTHHCPs located within
37 the upstate region.
38 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and]
39 2007, 2008 and 2009 for each regional group, the target medicaid revenue
40 percentage for the respective year shall be calculated by subtracting
41 the respective year's medicaid revenue reduction percentage from the
42 base period medicaid revenue percentage. The medicaid revenue reduction
43 percentages for 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
44 [and] 2007, 2008 and 2009 taking into account regional and program
45 differences in utilization of medicaid and medicare services, for the
46 following regional groups shall be equal to for each such year:
47 (i) one and one-tenth percentage points for CHHAs located within the
48 downstate region;
49 (ii) six-tenths of one percentage point for CHHAs located within the
50 upstate region;
51 (iii) one and eight-tenths percentage points for LTHHCPs located with-
52 in the downstate region; and
53 (iv) one and seven-tenths percentage points for LTHHCPs located within
54 the upstate region.
55 (c) For each regional group, the 1999 target medicaid revenue percent-
56 age shall be calculated by subtracting the 1999 medicaid revenue
S. 2108--C 169 A. 4308--C
1 reduction percentage from the base period medicaid revenue percentage.
2 The 1999 medicaid revenue reduction percentages, taking into account
3 regional and program differences in utilization of medicaid and medicare
4 services, for the following regional groups shall be equal to:
5 (i) eight hundred twenty-five thousandths (.825) of one percentage
6 point for CHHAs located within the downstate region;
7 (ii) forty-five hundredths (.45) of one percentage point for CHHAs
8 located within the upstate region;
9 (iii) one and thirty-five hundredths percentage points (1.35) for
10 LTHHCPs located within the downstate region; and
11 (iv) one and two hundred seventy-five thousandths percentage points
12 (1.275) for LTHHCPs located within the upstate region.
13 5. (a) For each regional group, if the 1996 medicaid revenue percent-
14 age is not equal to or less than the 1996 target medicaid revenue
15 percentage, the commissioner of health shall compare the 1996 medicaid
16 revenue percentage to the 1996 target medicaid revenue percentage to
17 determine the amount of the shortfall which, when divided by the 1996
18 medicaid revenue reduction percentage, shall be called the 1996
19 reduction factor. These amounts, expressed as a percentage, shall not
20 exceed one hundred percent. If the 1996 medicaid revenue percentage is
21 equal to or less than the 1996 target medicaid revenue percentage, the
22 1996 reduction factor shall be zero.
23 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
24 [and] 2007, 2008 and 2009 for each regional group, if the medicaid
25 revenue percentage for the respective year is not equal to or less than
26 the target medicaid revenue percentage for such respective year, the
27 commissioner of health shall compare such respective year's medicaid
28 revenue percentage to such respective year's target medicaid revenue
29 percentage to determine the amount of the shortfall which, when divided
30 by the respective year's medicaid revenue reduction percentage, shall be
31 called the reduction factor for such respective year. These amounts,
32 expressed as a percentage, shall not exceed one hundred percent. If the
33 medicaid revenue percentage for a particular year is equal to or less
34 than the target medicaid revenue percentage for that year, the reduction
35 factor for that year shall be zero.
36 6. (a) For each regional group, the 1996 reduction factor shall be
37 multiplied by the following amounts to determine each regional group's
38 applicable 1996 state share reduction amount:
39 (i) two million three hundred ninety thousand dollars ($2,390,000) for
40 CHHAs located within the downstate region;
41 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
42 within the upstate region;
43 (iii) one million two hundred seventy thousand dollars ($1,270,000)
44 for LTHHCPs located within the downstate region; and
45 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
46 located within the upstate region.
47 For each regional group reduction, if the 1996 reduction factor shall
48 be zero, there shall be no 1996 state share reduction amount.
49 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and]
50 2007, 2008 and 2009 for each regional group, the reduction factor for
51 the respective year shall be multiplied by the following amounts to
52 determine each regional group's applicable state share reduction amount
53 for such respective year:
54 (i) two million three hundred ninety thousand dollars ($2,390,000) for
55 CHHAs located within the downstate region;
S. 2108--C 170 A. 4308--C
1 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
2 within the upstate region;
3 (iii) one million two hundred seventy thousand dollars ($1,270,000)
4 for LTHHCPs located within the downstate region; and
5 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
6 located within the upstate region.
7 For each regional group reduction, if the reduction factor for a
8 particular year shall be zero, there shall be no state share reduction
9 amount for such year.
10 (c) For each regional group, the 1999 reduction factor shall be multi-
11 plied by the following amounts to determine each regional group's appli-
12 cable 1999 state share reduction amount:
13 (i) one million seven hundred ninety-two thousand five hundred dollars
14 ($1,792,500) for CHHAs located within the downstate region;
15 (ii) five hundred sixty-two thousand five hundred dollars ($562,500)
16 for CHHAs located within the upstate region;
17 (iii) nine hundred fifty-two thousand five hundred dollars ($952,500)
18 for LTHHCPs located within the downstate region; and
19 (iv) four hundred forty-two thousand five hundred dollars ($442,500)
20 for LTHHCPs located within the upstate region.
21 For each regional group reduction, if the 1999 reduction factor shall
22 be zero, there shall be no 1999 state share reduction amount.
23 7. (a) For each regional group, the 1996 state share reduction amount
24 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
25 on the basis of the extent of each CHHA's and LTHHCP's failure to
26 achieve the 1996 target medicaid revenue percentage, calculated on a
27 provider specific basis utilizing revenues for this purpose, expressed
28 as a proportion of the total of each CHHA's and LTHHCP's failure to
29 achieve the 1996 target medicaid revenue percentage within the applica-
30 ble regional group. This proportion shall be multiplied by the applica-
31 ble 1996 state share reduction amount calculation pursuant to paragraph
32 (a) of subdivision 6 of this section. This amount shall be called the
33 1996 provider specific state share reduction amount.
34 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
35 [and] 2007, 2008 and 2009 for each regional group, the state share
36 reduction amount for the respective year shall be allocated by the
37 commissioner of health among CHHAs and LTHHCPs on the basis of the
38 extent of each CHHA's and LTHHCP's failure to achieve the target medi-
39 caid revenue percentage for the applicable year, calculated on a provid-
40 er specific basis utilizing revenues for this purpose, expressed as a
41 proportion of the total of each CHHA's and LTHHCP's failure to achieve
42 the target medicaid revenue percentage for the applicable year within
43 the applicable regional group. This proportion shall be multiplied by
44 the applicable year's state share reduction amount calculation pursuant
45 to paragraph (b) or (c) of subdivision 6 of this section. This amount
46 shall be called the provider specific state share reduction amount for
47 the applicable year.
48 8. (a) The 1996 provider specific state share reduction amount shall
49 be due to the state from each CHHA and LTHHCP and may be recouped by the
50 state by March 31, 1997 in a lump sum amount or amounts from payments
51 due to the CHHA and LTHHCP pursuant to title 11 of article 5 of the
52 social services law.
53 (b) The provider specific state share reduction amount for 1997, 1998,
54 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, [and] 2007, 2008 and
55 2009 respectively, shall be due to the state from each CHHA and LTHHCP
56 and each year the amount due for such year may be recouped by the state
S. 2108--C 171 A. 4308--C
1 by March 31 of the following year in a lump sum amount or amounts from
2 payments due to the CHHA and LTHHCP pursuant to title 11 of article 5 of
3 the social services law.
4 9. CHHAs and LTHHCPs shall submit such data and information at such
5 times as the commissioner of health may require for purposes of this
6 section. The commissioner of health may use data available from third-
7 party payors.
8 10. On or about June 1, 1997, for each regional group the commissioner
9 of health shall calculate for the period August 1, 1996 through March
10 31, 1997 a medicaid revenue percentage, a reduction factor, a state
11 share reduction amount, and a provider specific state share reduction
12 amount in accordance with the methodology provided in paragraph (a) of
13 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
14 sion 6 and paragraph (a) of subdivision 7 of this section. The provider
15 specific state share reduction amount calculated in accordance with this
16 subdivision shall be compared to the 1996 provider specific state share
17 reduction amount calculated in accordance with paragraph (a) of subdivi-
18 sion 7 of this section. Any amount in excess of the amount determined in
19 accordance with paragraph (a) of subdivision 7 of this section shall be
20 due to the state from each CHHA and LTHHCP and may be recouped in
21 accordance with paragraph (a) of subdivision 8 of this section. If the
22 amount is less than the amount determined in accordance with paragraph
23 (a) of subdivision 7 of this section, the difference shall be refunded
24 to the CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
25 and LTHHCPs shall submit data for the period August 1, 1996 through
26 March 31, 1997 to the commissioner of health by April 15, 1997.
27 11. If a CHHA or LTHHCP fails to submit data and information as
28 required for purposes of this section:
29 (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
30 caid revenue percentage between the applicable base period and the
31 applicable target period for purposes of the calculations pursuant to
32 this section; and
33 (b) the commissioner of health shall reduce the current rate paid to
34 such CHHA and such LTHHCP by state governmental agencies pursuant to
35 article 36 of the public health law by one percent for a period begin-
36 ning on the first day of the calendar month following the applicable due
37 date as established by the commissioner of health and continuing until
38 the last day of the calendar month in which the required data and infor-
39 mation are submitted.
40 12. The commissioner of health shall inform in writing the director of
41 the budget and the chair of the senate finance committee and the chair
42 of the assembly ways and means committee of the results of the calcu-
43 lations pursuant to this section.
44 § 86. Subdivision 5-a of section 246 of chapter 81 of the laws of
45 1995, amending the public health law and other laws relating to medical
46 reimbursement and welfare reform, as amended by section 89 of part A of
47 chapter 57 of the laws of 2006, is amended to read as follows:
48 5-a. Section sixty-four-a of this act shall be deemed to have been in
49 full force and effect on and after April 1, 1995 through March 31, 1999
50 and on and after July 1, 1999 through March 31, 2000 and on and after
51 April 1, 2000 through March 31, 2003 and on and after April 1, 2003
52 through March 31, 2007, and on and after April 1, 2007 through March 31,
53 2009;
54 § 87. Section 64-b of chapter 81 of the laws of 1995, amending the
55 public health law and other laws relating to medical reimbursement and
S. 2108--C 172 A. 4308--C
1 welfare reform, as amended by section 90 of part A of chapter 57 of the
2 laws of 2006, is amended to read as follows:
3 § 64-b. Notwithstanding any inconsistent provision of law, the
4 provisions of subdivision 7 of section 3614 of the public health law, as
5 amended, shall remain and be in full force and effect on April 1, 1995
6 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
7 and after April 1, 2000 through March 31, 2003 and on and after April 1,
8 2003 through March 31, 2007, and on and after April 1, 2007 through
9 March 31, 2009.
10 § 88. Subdivision 11 of section 2807-c of the public health law is
11 amended by adding a new paragraph (s-8) to read as follows:
12 (s-8) To the extent funds are available and otherwise notwithstanding
13 any inconsistent provision of law to the contrary, for rate periods on
14 and after April first, two thousand seven through March thirty-first,
15 two thousand eight, the commissioner shall increase rates of payment for
16 patients eligible for payments made by state governmental agencies by an
17 amount not to exceed sixty million dollars annually in the aggregate.
18 Such amount shall be allocated among those voluntary non-profit general
19 hospitals which continue to provide inpatient services as of April
20 first, two thousand seven through March thirty-first, two thousand eight
21 and which have medicaid inpatient discharges percentages equal to or
22 greater than thirty-five percent. This percentage shall be computed
23 based upon data reported to the department in each hospital's two thou-
24 sand four institutional cost report, as submitted to the department on
25 or before January first, two thousand seven. The rate adjustments calcu-
26 lated in accordance with this paragraph shall be allocated propor-
27 tionally based on each eligible hospital's total reported medicaid inpa-
28 tient discharges in two thousand four, to the total reported medicaid
29 inpatient discharges for all such eligible hospitals in two thousand
30 four, provided, however, that such rate adjustments shall be subject to
31 reconciliation to ensure that each hospital receives in the aggregate
32 its proportionate share of the full allocation to the extent allowable
33 under federal law. Such payments may be added to rates of payment or
34 made as aggregate payments to eligible hospitals, provided, however,
35 that subject to the availability of federal financial participation and
36 solely for the period April first, two thousand seven through March
37 thirty-first, two thousand eight, six million dollars in the aggregate
38 of this sixty million dollars shall be allocated to voluntary non-profit
39 hospitals which continue to provide inpatient services as of April
40 first, two thousand seven through March thirty-first, two thousand eight
41 and which have Medicaid inpatient discharge percentages of less than
42 thirty-five percent and which had previously qualified for distributions
43 pursuant to paragraph (s-7) of this subdivision. The rate adjustment
44 calculated in accordance with this paragraph shall be allocated propor-
45 tionally based on the amount of money the hospital had received in two
46 thousand six.
47 § 89. Subdivision 7-a of section 3614 of the public health law, as
48 amended by section 38 of part C of chapter 109 of the laws of 2006, is
49 amended to read as follows:
50 7-a. Notwithstanding any inconsistent provision of law or regulation,
51 for the purposes of establishing rates of payment by governmental agen-
52 cies for long term home health care programs for the period April first,
53 two thousand five, through December thirty-first, two thousand five, and
54 for the period January first, two thousand six through March thirty-
55 first, two thousand seven, and on and after April first, two thousand
56 seven through March thirty-first, two thousand nine, the reimbursable
S. 2108--C 173 A. 4308--C
1 base year administrative and general costs of a provider of services
2 shall not exceed the statewide average of total reimbursable base year
3 administrative and general costs of such providers of services.
4 No such limit shall be applied to a provider of services reimbursed on
5 an initial budget basis, or a new provider, excluding changes in owner-
6 ship or changes in name, who begins operations in the year prior to the
7 year which is used as a base year in determining rates of payment.
8 For the purposes of this subdivision, reimbursable base year opera-
9 tional costs shall mean those base year operational costs remaining
10 after application of all other efficiency standards, including, but not
11 limited to, cost guidelines.
12 The limitation on reimbursement for provider administrative and gener-
13 al expenses provided by this subdivision shall be expressed as a
14 percentage reduction for the rate promulgated by the commissioner to
15 each long term home health care program provider.
16 § 89-a. 1. Notwithstanding paragraph (c) of subdivision 10 of section
17 2807-c of the public health law and section 21 of chapter 1 of the laws
18 of 1999 and any other inconsistent provision of law or regulation to the
19 contrary, in determining rates of payments by state governmental agen-
20 cies effective for services provided beginning April 1, 2006, through
21 March 31, 2009 for inpatient and outpatient services provided by general
22 hospitals and for inpatient services and outpatient adult day health
23 care services provided by residential health care facilities pursuant to
24 article 28 of the public health law, the commissioner of health shall
25 apply a trend factor projection of two and twenty-five hundredths
26 percent attributable to the period January 1, 2006 through December 31,
27 2006, and on and after January 1, 2007, provided, however, that on
28 reconciliation of such trend factor for the period January 1, 2006
29 through December 31, 2006 pursuant to paragraph (c) of subdivision 10 of
30 section 2807-c of the public health law, such trend factor shall be the
31 final US Consumer Price Index (CPI) for all urban consumers, as
32 published by the US Department of Labor, Bureau of Labor Statistics less
33 twenty-five hundredths of a percentage point.
34 2. The commissioner of health shall adjust rates of payment to reflect
35 the exclusion pursuant to this section of such specified trend factor
36 projections or adjustments.
37 § 90. Notwithstanding any inconsistent provision of law, rule or regu-
38 lation, for purposes of implementing the provisions of the public health
39 law and the social services law, references to titles XIX and XXI of the
40 federal social security act in the public health law and the social
41 services law shall be deemed to include and also to mean any successor
42 titles thereto under the federal social security act.
43 § 91. Notwithstanding any inconsistent provision of law, rule or regu-
44 lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b of section
45 2807 of the public health law and section 18 of chapter 2 of the laws of
46 1988, as they relate to time frames for notice, approval or certif-
47 ication of rates of payment, are hereby suspended and shall, for
48 purposes of implementing the provisions of this act, be deemed to have
49 been without any force or effect from and after November 1, 2006 for
50 such rates effective for the period January 1, 2007 through December 31,
51 2007.
52 § 92. Severability clause. If any clause, sentence, paragraph, subdi-
53 vision, section or part of this act shall be adjudged by any court of
54 competent jurisdiction to be invalid, such judgment shall not affect,
55 impair or invalidate the remainder thereof, but shall be confined in its
56 operation to the clause, sentence, paragraph, subdivision, section or
S. 2108--C 174 A. 4308--C
1 part thereof directly involved in the controversy in which such judgment
2 shall have been rendered. It is hereby declared to be the intent of the
3 legislature that this act would have been enacted even if such invalid
4 provisions had not been included herein.
5 § 93. This act shall take effect immediately and shall be deemed to
6 have been in full force and effect on and after April 1, 2007; provided,
7 however, that:
8 1. sections one, one-a, one-b, one-c, one-d, and one-e of this act
9 shall take effect January 1, 2008;
10 1-a. sections one-f, one-g, and one-h of this act shall take effect
11 July 1, 2007, provided that the amendment to section 364-j of the social
12 services law made by section one-g of this act shall not affect the
13 repeal of such section and shall be deemed repealed therewith;
14 2. section two of this act shall expire and be deemed repealed on
15 March 31, 2010;
16 3. section twenty-three of this act shall take effect July 1, 2007,
17 provided that the amendments to subdivision 9 of section 367-a of the
18 social services law made by such section shall not affect the repeal of
19 such subdivision and shall be deemed repealed therewith;
20 4. section thirty of this act shall be deemed to have been in full
21 force and effect on and after April 1, 2005;
22 5. section thirty-nine of this act shall apply to claims filed or
23 presented prior to, on or after April 1, 2007;
24 6. section fifty-six of this act shall be deemed to have been in full
25 force and effect on and after April 1, 2006;
26 6-a. section fifty-seven of this act shall expire and be deemed
27 repealed on March 31, 2010; provided that such section shall not apply
28 to any person as to whom federal financial participation is available
29 for the costs of services provided under the provisions of subdivision 4
30 of section 366-c of the social services law in effect immediately prior
31 to the effective date of this act.
32 7. the amendments to section 4403-f of the public health law made by
33 sections six, seven, eight, nine, ten, eleven, twelve, fourteen,
34 fifteen, sixteen, seventeen, eighteen, nineteen, twenty, twenty-one and
35 twenty-two of this act shall not affect the repeal of such section and
36 shall be deemed repealed therewith;
37 8. the amendments to section 2807-c of the public health law made by
38 sections thirty-four, seventy, seventy-one, seventy-two and seventy-
39 three of this act shall not affect the expiration of such paragraphs and
40 shall be deemed to expire therewith;
41 9. any rules or regulations necessary to implement the provisions of
42 this act may be promulgated and any procedures, forms, or instructions
43 necessary for such implementation may be adopted and issued on or after
44 the date this act shall have become a law;
45 10. this act shall not be construed to alter, change, affect, impair
46 or defeat any rights, obligations, duties or interests accrued, incurred
47 or conferred prior to the enactment of this act;
48 11. the commissioner of health and the superintendent of insurance and
49 any appropriate council may take any steps necessary to implement this
50 act prior to its effective date;
51 12. notwithstanding any inconsistent provision of the state adminis-
52 trative procedure act or any other provision of law, rule or regulation,
53 the commissioner of health and the superintendent of insurance and any
54 appropriate council is authorized to adopt or amend or promulgate on an
55 emergency basis any regulation he or she or such council determines
S. 2108--C 175 A. 4308--C
1 necessary to implement any provision of this act on its effective date;
2 and
3 13. the provisions of this act shall become effective notwithstanding
4 the failure of the commissioner of health or the superintendent of
5 insurance or any council to adopt or amend or promulgate regulations
6 implementing this act.
7 PART D
8 Section 1. Paragraph (a) of subdivision 2 of section 43.04 of the
9 mental hygiene law is amended by adding a new subparagraph (iii) to read
10 as follows:
11 (iii) For each provider of services in the categories of services set
12 forth in subdivision one of this section, excluding, on and after April
13 first, nineteen hundred ninety-four, providers of day treatment
14 services, located in Regions II and III, as defined in the methodology
15 established pursuant to paragraph (ii) of subdivision (c) of section
16 43.02 of this article, notwithstanding any other provision of this para-
17 graph, the total assessment shall be six percent of each such provider's
18 gross receipts received on a cash basis for all services rendered,
19 beginning April first, nineteen hundred ninety-seven, and five and five-
20 tenths percent of each such provider's gross receipts received on a cash
21 basis for all services rendered, beginning January first, two thousand
22 eight.
23 § 2. Paragraph (b) of subdivision 2 of section 43.04 of the mental
24 hygiene law is amended by adding a new subparagraph (iii) to read as
25 follows:
26 (iii) For each provider of services in the categories of services set
27 forth in subdivision one of this section, excluding, on and after April
28 first, nineteen hundred ninety-four, providers of day treatment
29 services, located in Region I, as defined in the methodology established
30 pursuant to paragraph (ii) of subdivision (c) of section 43.02 of this
31 article, notwithstanding any other provision of this paragraph, the
32 total assessment shall be six percent of each such provider's gross
33 receipts received on a cash basis for all services rendered, beginning
34 April first, nineteen hundred ninety-seven, and five and five-tenths
35 percent of each such provider's gross receipts received on a cash basis
36 for all services rendered, beginning January first, two thousand eight.
37 § 3. Paragraph (c) of subdivision 2 of section 43.04 of the mental
38 hygiene law is amended by adding a new subparagraph (iii) to read as
39 follows:
40 (iii) For each provider of services as set forth in clause (ii) of
41 subdivision one of this section in the category of intermediate care
42 facilities for persons who are developmentally disabled operated by the
43 office of mental retardation and developmental disabilities, notwith-
44 standing any other provision of this paragraph, the total assessment
45 shall be six percent of the provider's gross receipts received on a cash
46 basis for all services rendered, beginning April first, two thousand
47 one, and five and five-tenths percent of the provider's gross receipts
48 received on a cash basis for all services rendered, beginning January
49 first, two thousand eight.
50 § 4. This act shall take effect immediately, provided that sections
51 one and two of this act shall be deemed to have been in full force and
52 effect on and after April 1, 1997 and section three of this act shall be
53 deemed to have been in full force and effect on and after April 1, 2001.
54 PART E
S. 2108--C 176 A. 4308--C
1 Section 1. Subparagraphs h and i of paragraph 2 of subdivision (b) of
2 section 5.07 of the mental hygiene law, as added by chapter 322 of the
3 laws of 1992, are amended and a new subparagraph j is added to read as
4 follows:
5 h. a description of the involvement of local government mental health
6 authorities in the planning and development of a needs-based, comprehen-
7 sive service system and in the determination of the allocation of
8 resources; [and]
9 i. to the extent practicable, all such information required pursuant
10 to this paragraph shall be provided on a statewide, regional and indi-
11 vidual state-operated hospital and state-operated research institute
12 basis[.]; and
13 j. recommendations on the provision of state and local mental health
14 services based on the development of best practices by programs promot-
15 ing culturally and linguistically competent mental health services.
16 § 2. Section 7.07 of the mental hygiene law is amended by adding a new
17 subdivision (f) to read as follows:
18 (f) The office shall establish, and provide technical and financial
19 support to establish two programs promoting culturally and linguis-
20 tically competent mental health services. Such programs shall be oper-
21 ated in a collaborative manner with the Nathan S. Kline Institute for
22 Psychiatric Research, the New York State Psychiatric Institute, acade-
23 mia, mental health care providers, communities interested in the mental-
24 ly ill and other interested private and public sector parties. The
25 programs, in consultation with the office's multicultural advisory
26 committee, shall investigate and report, to the commissioner on a bian-
27 nual basis recommendations as to best practices for the delivery of
28 culturally and linguistically competent mental health services to under-
29 served populations affected by disparities due to cultural, linguistic
30 and systemic barriers.
31 § 3. This act shall take effect immediately.
32 PART F
33 Section 1. This act shall be known and may be cited as the "mental
34 retardation and developmental disabilities services quality improvement
35 program".
36 § 2. The mental hygiene law is amended by adding a new section 16.35
37 to read as follows:
38 § 16.35 Mental retardation and developmental disabilities services qual-
39 ity improvement demonstration program.
40 (a) For purposes of this section "facility" means any not-for-profit
41 or public agency regulated by the office that provides services funded
42 in whole or in part by the state.
43 (b) Notwithstanding any law, rule or regulation to the contrary, the
44 commissioner shall, within amounts appropriated, including federal
45 financial participation if available, establish a demonstration program
46 to improve the quality of care for facility clients through the increase
47 or improvement of direct care staff at such facilities. In furtherance
48 of such demonstration program for facilities selected through a compet-
49 itive process, rates of payment or state aid shall be adjusted accord-
50 ingly. Requests for proposals for eligible projects shall be issued by
51 the commissioner.
52 (c) Such eligible projects shall be designated by the commissioner and
53 may include:
S. 2108--C 177 A. 4308--C
1 (1) an increase in direct care staff, either facility wide or targeted
2 at a particular area of care or shift;
3 (2) increased training and education of direct care staff, including
4 allowing direct care staff to increase their level of licensure or
5 certification relevant to facility care;
6 (3) efforts to decrease staff turn-over through wage, employee benefit
7 improvements, or other means; and
8 (4) other efforts related to the recruitment and retention of direct
9 care staff that will effect the quality of care at such facility.
10 (d) The commissioner shall consider, in selecting projects, the like-
11 lihood that such project will improve the care for the residents of the
12 facility, the financial need of the facility and such other matters as
13 the commissioner deems appropriate.
14 (e) Adjustments to rates of payment or state aid made pursuant to this
15 section shall be subject to available appropriations and shall not, in
16 aggregate, exceed five million dollars annually. The program shall
17 commence on April first, two thousand seven and end on March thirty-
18 first, two thousand ten.
19 (f) On or before June thirtieth, two thousand ten, the commissioner
20 shall contract with an independent consultant to evaluate and report to
21 the commissioner, the speaker of the assembly and the temporary presi-
22 dent of the senate on the impact that the demonstration project has had
23 upon direct care staff recruitment, retention and quality of services
24 provided.
25 § 3. This act shall take effect immediately.
26 PART G
27 Section 1. Notwithstanding any inconsistent provision of law or regu-
28 lation to the contrary, the commissioner of health, in consultation with
29 the commissioner of mental retardation and developmental disabilities
30 and other interested stakeholders, shall review medicaid reimbursement
31 for the provision of long term therapies and psychotherapy by licensed
32 clinical social workers in programs licensed pursuant to article 16 of
33 the mental hygiene law and article 28 of the public health law, and
34 shall advise the governor and the legislature of relevant findings on or
35 before January 1, 2008.
36 § 2. This act shall take effect immediately and shall be deemed to
37 have been in full force and effect on and after April 1, 2007.
38 PART H
39 Section 1. Article 2 of the public health law is amended by adding a
40 new title 5-A to read as follows:
41 TITLE 5-A
42 EMPIRE STATE STEM CELL BOARD
43 Section 265. Definition.
44 265-a. Empire state stem cell board.
45 265-b. Funding committee.
46 265-c. Ethics committee.
47 265-d. Members.
48 265-e. Public and financial accountability standards.
49 265-f. Severability.
50 § 265. Definition. As used or referred to in this title, unless a
51 different meaning clearly appears from the context "stem cell" means
52 stem or progenitor cells that divide and are capable of generating one
S. 2108--C 178 A. 4308--C
1 or more different types of progeny. Stem cells and their progeny can
2 potentially repair or replace specific tissues or be used to develop
3 disease models.
4 § 265-a. Empire state stem cell board. 1. The empire state stem cell
5 board ("board"), comprised of a funding committee and an ethics commit-
6 tee, both of which shall be chaired by the commissioner, is hereby
7 created within the department for the purpose of administering the
8 empire state stem cell trust fund ("fund"), created pursuant to section
9 ninety-nine-p of the state finance law. The board is hereby empowered,
10 subject to annual appropriations and other funding authorized or made
11 available, to make grants to basic, applied, translational or other
12 research and development activities that will advance scientific discov-
13 eries in fields related to stem cell biology.
14 2. No grants made available in the fund from any source shall be
15 directly or indirectly utilized for research involving human reproduc-
16 tive cloning.
17 3. Notwithstanding any other provision of law, the board shall have
18 the authority to adopt by laws to govern its proceedings including but
19 not limited to rules respecting quorums and the number of votes needed
20 to require the award of grants. No grants may be awarded by the board
21 prior to the establishment of bylaws that must include merit based peer
22 review application guidelines. Such bylaws must be approved by the fund-
23 ing committee.
24 4. Grants may be made for one or more years, provided, however, that
25 no grant shall be made for which the annual commitment is more than
26 fifteen percent of the total funds available in any year. However, no
27 single institution shall be awarded more than twenty-five percent of the
28 total amount appropriated. This limitation shall be considered separate-
29 ly for each new proposal without aggregating any prior year approvals
30 that may fund research activities. This requirement shall be determina-
31 tive, unless two-thirds of the funding committee approves a higher limit
32 for a particular grantee.
33 5. The existence of the empire state stem cell board shall continue
34 until there are no longer any assets or money available for distrib-
35 ution.
36 § 265-b. Funding committee. 1. There shall be a funding committee
37 which shall have thirteen members appointed by the governor, except for
38 the commissioner who shall serve as an ex officio member. Six members
39 shall be appointed directly by the governor; two shall be appointed on
40 the nomination of the temporary president of the senate; two shall be
41 appointed on the nomination of the speaker of the assembly; one shall be
42 appointed on the nomination the senate minority leader and one shall be
43 appointed on the nomination of the assembly minority leader. A member of
44 the funding committee shall also serve on the ethics committee.
45 2. The funding committee shall perform the following functions:
46 (a) provide for an independent scientific peer review committee
47 composed of individuals with expertise in the field of biomedical
48 research who shall review grant applications based on the criteria
49 requirements and standards adopted by the funding committee, and make
50 recommendations to the funding committee for the award of grants;
51 (b) develop criteria including an appropriate competitive scoring
52 method, standards, and requirements for considering funding applications
53 and for awarding research grants, including but not limited to recommen-
54 dations for the overhead/indirect component of such grants for the
55 development and submission of funding applications by New York state
56 based consortia;
S. 2108--C 179 A. 4308--C
1 (c) recommend standards for the scientific and medical oversight of
2 awards;
3 (d) solicit through requests for proposals and otherwise, and to
4 accept proposals for research projects including grant applications;
5 (e) review grant applications based on the criteria, requirements, and
6 standards adopted by the funding committee utilizing a process that
7 gives due consideration to the amount of nonpublic funds contributed by
8 the project sponsor, including cash, in-kind personnel, equipment or
9 materials, donations, the opportunity to leverage funds, including
10 federal, private and not-for-profit funds reasonably anticipated to be
11 received by the project sponsors; provided, however, that nonpublic
12 funds shall only be considered as a factor by the funding committee when
13 reviewing applications of equivalent merit as determined by the inde-
14 pendent scientific peer review committee;
15 (f) make recommendations to the commissioner for the award of research
16 therapy development and clinical trial grants; and
17 (g) recommend standards for the evaluation of grantees to ensure that
18 they comply with all applicable requirements, including, but not limited
19 to, conducting peer group progress oversight reviews of grantees to
20 ensure compliance with the terms of the award and report to the commis-
21 sioner any recommendations or subsequent action. Such standards shall
22 mandate periodic reporting by grantees.
23 3. With the exception of the ex officio member, the funding committee
24 shall be divided into three classes. Of the three classes, the first
25 class appointed shall include three of the governor's appointees, one
26 appointee nominated by the temporary president of the senate, and one
27 appointee nominated by the speaker of the assembly and shall serve for a
28 term ending one year from the effective date of this title. The second
29 class shall include two of the governor's appointees, one appointee
30 nominated by the minority leader of the senate, and one appointee nomi-
31 nated by the minority leader of the assembly and shall serve for a term
32 ending two years from the effective date of this title. The third class
33 shall include the final governor's appointee, one appointee nominated by
34 the temporary president of the senate, and one appointee nominated by
35 the speaker of the assembly; and shall serve for a term ending three
36 years from the effective date of this title. Subsequently, each member
37 appointed shall serve a term of three years and no more than two terms
38 of three years each. A vacancy in the membership of the board shall be
39 filled for the unexpired portion of the term in the same manner as the
40 original appointment.
41 § 265-c. Ethics committee. 1. There shall be an ethics committee which
42 shall have thirteen members appointed by the governor, except for the
43 commissioner who shall serve as an ex officio member. Six members shall
44 be appointed directly by the governor; two shall be appointed on the
45 nomination of the temporary president of the senate; two shall be
46 appointed on the nomination of the speaker of the assembly; one shall be
47 appointed on the nomination of the senate minority leader; and one shall
48 be appointed on the nomination of the assembly minority leader. A member
49 of the ethics committee shall also serve on the funding committee.
50 2. The ethics committee shall make recommendations to the funding
51 committee regarding:
52 (a) scientific, medical, and ethical standards;
53 (b) standards for all medical, socioeconomic, and financial aspects of
54 clinical trials and therapy delivery to patients, including, but not
55 limited to standards for safe and ethical procedures for: obtaining
56 materials and cells for research; clinical efforts for the appropriate
S. 2108--C 180 A. 4308--C
1 treatment of human subjects in medical research; and ensuring compliance
2 with patient privacy laws;
3 (c) oversight of funded research to ensure compliance with the stand-
4 ards described in paragraphs (a) and (b) of this subdivision; and
5 (d) relevant ethical and regulatory issues.
6 3. With the exception of the ex officio member, the ethics committee
7 shall be divided into three classes. Of the three classes, the first
8 class appointed shall include three of the governor's appointees, one
9 appointee nominated by the temporary president of the senate, and one
10 appointee nominated by the speaker of the assembly; and shall serve for
11 a term ending one year from the effective date of this title. The second
12 class shall include two of the governor's appointees, one appointee
13 nominated by the minority leader of the senate, and one appointee nomi-
14 nated by the minority leader of the assembly; and shall serve for a term
15 ending two years from the effective date of this title. The third class
16 shall include the final governor's appointee, one appointee nominated by
17 the temporary president of the senate, and one appointee nominated by
18 the speaker of the assembly; and shall serve for a term ending three
19 years from the effective date of this title. Subsequently, each member
20 appointed shall serve a term of three years and no more than two terms
21 of three years each. A vacancy in the membership of the board shall be
22 filled for the unexpired portion of the term in the same manner as the
23 original appointment.
24 § 265-d. Members. 1. The members of the funding and ethics committees
25 shall serve without compensation, but shall be entitled to reimbursement
26 for actual and necessary expenses incurred in the performance of their
27 official duties. Such members, except as otherwise provided by law, may
28 engage in private employment, or in a profession or business.
29 2. The provisions of section seventeen of the public officers law
30 shall apply to members of the committees.
31 3. The provisions of article seven of the public officers law shall
32 apply to meetings of the funding and ethics committees.
33 § 265-e. Public and financial accountability standards. 1. Report. The
34 board shall issue an annual report to the public, which sets forth its
35 activities, grants awarded, grants in progress, research accomplish-
36 ments, and future program directions. Each annual report shall include,
37 but not be limited to the following:
38 (a) number and dollar amounts of research and facilities grants;
39 (b) grantees for the prior year;
40 (c) board's administrative expenses;
41 (d) summary of research findings, including promising new research
42 areas; and
43 (e) strategic plan of the board.
44 2. Conflicts of interest. No employee of the board or member of the
45 funding or ethics committees shall make, participate in making, or in
46 any way attempt to use his or her position to influence a decision to
47 approve or award a grant, loan, or contract to:
48 (a) his or her employer or relative, or any entity in which the
49 employee, member of the board, or member of the advisory counsel or the
50 relative of any such individual has a financial interest; or
51 (b) an organization in which such employee, member of the board,
52 member of the advisory counsel, or any relative of any such individual
53 is an officer, director or partner of such organization.
54 3. Patent royalties and license revenues. The board shall establish
55 standards that require that all grants be subject to intellectual prop-
56 erty agreements that establish the scope, if any, of the state's owner-
S. 2108--C 181 A. 4308--C
1 ship or other financial interest in the commercialization and other
2 benefits of the results, products, inventions and discoveries of state-
3 funded stem cell research, and shall also include consideration in such
4 agreement for amounts of funding from sources other than the state.
5 4. Contributions to the board. Notwithstanding any other provisions of
6 the law to the contrary, the board is authorized to receive contrib-
7 utions from any governmental entity, for profit and not-for-profit
8 corporation, association or person.
9 § 235-f. Severability. If any clause, sentence, paragraph, section or
10 part of this title shall be adjudged by any court of competent jurisdic-
11 tion to be invalid, such judgment shall not affect, impair or invalidate
12 the remainder thereof, but shall be confined in its operation to the
13 clause, sentence, paragraph, section or part thereof, directly involved
14 in the controversy in which such judgment shall have been rendered.
15 § 2. Subdivision 1 of section 17 of the public officers law is amended
16 by adding a new paragraph (u) to read as follows:
17 (u) For the purposes of this section, the term "employee" shall
18 include the members of the empire state stem cell board within the
19 department of health.
20 § 3. The state finance law is amended by adding a new section 99-p to
21 read as follows:
22 § 99-p. Empire state stem cell trust fund. 1. There is hereby estab-
23 lished in the joint custody of the state comptroller and the commission-
24 er of taxation and finance a special revenue fund to be known as the
25 "empire state stem cell trust fund".
26 2. The fund shall consist of all monies appropriated for its purpose,
27 all monies required by this section or any other provisions of law to be
28 paid into or credited to such fund. Nothing contained herein shall
29 prevent the department of health from receiving grants, gifts or
30 bequests for the purposes of the fund as defined in this section and
31 depositing them into the fund according to law.
32 3. Monies of the fund when allocated, shall be available for adminis-
33 trative costs of the empire state stem cell board established pursuant
34 to title 5-A of article two of the public health law administered by the
35 commissioner of health and for funding stem cell research.
36 4. Money shall be payable from the fund on the audit and warrant of
37 the state comptroller on vouchers approved and certified by the commis-
38 sioner of health.
39 § 4. This act shall take effect immediately and shall be deemed to
40 have been in full force and effect on and after April 1, 2007.
41 § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
42 sion, section or part of this act shall be adjudged by any court of
43 competent jurisdiction to be invalid, such judgment shall not affect,
44 impair, or invalidate the remainder thereof, but shall be confined in
45 its operation to the clause, sentence, paragraph, subdivision, section
46 or part thereof directly involved in the controversy in which such judg-
47 ment shall have been rendered. It is hereby declared to be the intent of
48 the legislature that this act would have been enacted even if such
49 invalid provisions had not been included herein.
50 § 3. This act shall take effect immediately provided, however, that
51 the applicable effective date of Parts A through H of this act shall be
52 as specifically set forth in the last section of such Parts.
